Provider Demographics
NPI:1528111218
Name:BIRON, LAURA KOLOMIEC (RD, CD)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:KOLOMIEC
Last Name:BIRON
Suffix:
Gender:F
Credentials:RD, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:574 W SHAW HILL RD
Mailing Address - Street 2:
Mailing Address - City:STOWE
Mailing Address - State:VT
Mailing Address - Zip Code:05672-4612
Mailing Address - Country:US
Mailing Address - Phone:802-253-9586
Mailing Address - Fax:802-253-6808
Practice Address - Street 1:1069 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:STOWE
Practice Address - State:VT
Practice Address - Zip Code:05672-4749
Practice Address - Country:US
Practice Address - Phone:802-253-9586
Practice Address - Fax:802-253-6808
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0740000186133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered