Provider Demographics
NPI:1639461619
Name:LARSON, SARAH ELIZABETH FLINN (MS, RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ELIZABETH FLINN
Last Name:LARSON
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 METACOM AVE
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:RI
Mailing Address - Zip Code:02809-5131
Mailing Address - Country:US
Mailing Address - Phone:401-396-9331
Mailing Address - Fax:401-396-9369
Practice Address - Street 1:685 METACOM AVE
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:RI
Practice Address - Zip Code:02809-5131
Practice Address - Country:US
Practice Address - Phone:401-396-9331
Practice Address - Fax:401-396-9369
Is Sole Proprietor?:No
Enumeration Date:2011-05-09
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3044133VN1004X, 133V00000X
RILDN00754133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric