Provider Demographics
NPI:1477125995
Name:HARCOURT, SARA (DIETITIAN, MS RD MPH)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:HARCOURT
Suffix:
Gender:F
Credentials:DIETITIAN, MS RD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 300586
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD
Mailing Address - State:UT
Mailing Address - Zip Code:84730-0586
Mailing Address - Country:US
Mailing Address - Phone:801-516-9497
Mailing Address - Fax:
Practice Address - Street 1:1000 N MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:UT
Practice Address - Zip Code:84701-2061
Practice Address - Country:US
Practice Address - Phone:435-893-0569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT962979133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered