Provider Demographics
NPI:1679847313
Name:SADLER, SUZAN (RD, CLC)
Entity Type:Individual
Prefix:
First Name:SUZAN
Middle Name:
Last Name:SADLER
Suffix:
Gender:F
Credentials:RD, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 REMIGIO RD
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02763-4002
Mailing Address - Country:US
Mailing Address - Phone:508-212-2857
Mailing Address - Fax:
Practice Address - Street 1:31 REMIGIO RD
Practice Address - Street 2:
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02763-4002
Practice Address - Country:US
Practice Address - Phone:508-212-2857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAALPP-34217174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN