Provider Demographics
NPI:1710647383
Name:AGNOLI, SARAH JANE (RD)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:JANE
Last Name:AGNOLI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 STOWELL RD
Mailing Address - Street 2:
Mailing Address - City:THETFORD CTR
Mailing Address - State:VT
Mailing Address - Zip Code:05075-8760
Mailing Address - Country:US
Mailing Address - Phone:802-249-6817
Mailing Address - Fax:
Practice Address - Street 1:90 SWIFTWATER RD
Practice Address - Street 2:
Practice Address - City:WOODSVILLE
Practice Address - State:NH
Practice Address - Zip Code:03785-1446
Practice Address - Country:US
Practice Address - Phone:603-747-9723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-23
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1251133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered