Provider Demographics
NPI:1326394289
Name:LAROCQUE, SARAH CATHERINE (RD)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:CATHERINE
Last Name:LAROCQUE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:355 WAVERLEY OAKS RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02452-8474
Mailing Address - Country:US
Mailing Address - Phone:781-314-7600
Mailing Address - Fax:781-314-7666
Practice Address - Street 1:355 WAVERLEY OAKS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02452-8474
Practice Address - Country:US
Practice Address - Phone:781-314-7600
Practice Address - Fax:781-314-7666
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2929133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered