Provider Demographics
NPI:1629515473
Name:SAWICKI, SARA (MS, RDN, LD, RYT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:SAWICKI
Suffix:
Gender:F
Credentials:MS, RDN, LD, RYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 HOSPITAL PKWY STE 225
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-1828
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6300 HOSPITAL PKWY STE 225
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-1828
Practice Address - Country:US
Practice Address - Phone:678-407-2159
Practice Address - Fax:678-780-4313
Is Sole Proprietor?:No
Enumeration Date:2017-01-31
Last Update Date:2023-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD004783133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered