Provider Demographics
NPI:1760618037
Name:HANSEN, SABINA (RD)
Entity Type:Individual
Prefix:
First Name:SABINA
Middle Name:
Last Name:HANSEN
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 1:31 E DARRAH LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-3763
Mailing Address - Country:US
Mailing Address - Phone:609-403-6190
Mailing Address - Fax:609-403-6191
Practice Address - Street 1:31 E DARRAH LN
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-3763
Practice Address - Country:US
Practice Address - Phone:609-403-6190
Practice Address - Fax:609-403-6191
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-01
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL854518133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered