Provider Demographics
NPI:1528601895
Name:SABAT, MARY-ELLEN (MS, RDN, LD)
Entity Type:Individual
Prefix:
First Name:MARY-ELLEN
Middle Name:
Last Name:SABAT
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 DEVONSHIRE FARMS WAY
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:GA
Mailing Address - Zip Code:30004-4322
Mailing Address - Country:US
Mailing Address - Phone:404-918-2941
Mailing Address - Fax:770-664-8013
Practice Address - Street 1:600 DEVONSHIRE FARMS WAY
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:GA
Practice Address - Zip Code:30004-4322
Practice Address - Country:US
Practice Address - Phone:404-918-2941
Practice Address - Fax:770-664-8013
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-19
Last Update Date:2019-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA011115133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered