Provider Demographics
NPI:1730129511
Name:SAUSSOTTE, MARY ANN ELIZABETH (MS, RD, CNSD)
Entity Type:Individual
Prefix:MRS
First Name:MARY ANN
Middle Name:ELIZABETH
Last Name:SAUSSOTTE
Suffix:
Gender:F
Credentials:MS, RD, CNSD
Other - Prefix:MISS
Other - First Name:MARY ANN
Other - Middle Name:ELIZABETH
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, CNSD
Mailing Address - Street 1:265 S BUCHANAN CIR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-9526
Mailing Address - Country:US
Mailing Address - Phone:303-216-1098
Mailing Address - Fax:303-665-9601
Practice Address - Street 1:200 EXEMPLA CIR
Practice Address - Street 2:EXEMPLA GOOD SAMARITAN: HHC
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3370
Practice Address - Country:US
Practice Address - Phone:303-689-6580
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered