Provider Demographics
NPI:1477320257
Name:HEFFRON, SARAH M (RDN, CSO)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:M
Last Name:HEFFRON
Suffix:
Gender:F
Credentials:RDN, CSO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10718 CAROLINA PINES DR
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:OH
Mailing Address - Zip Code:45030-4933
Mailing Address - Country:US
Mailing Address - Phone:513-364-4042
Mailing Address - Fax:
Practice Address - Street 1:10718 CAROLINA PINES DR
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:OH
Practice Address - Zip Code:45030-4933
Practice Address - Country:US
Practice Address - Phone:513-364-4042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4719133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered