Provider Demographics
NPI:1811385875
Name:HEALY, SARAH RAY (MS, RD, LDN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:RAY
Last Name:HEALY
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:RAY
Other - Last Name:HYLTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6130 MOUNTAINWELL DR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-7309
Mailing Address - Country:US
Mailing Address - Phone:727-239-1480
Mailing Address - Fax:
Practice Address - Street 1:1802 ABBEY CT
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-6017
Practice Address - Country:US
Practice Address - Phone:678-554-7576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-29
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL004415133V00000X
GALD004826133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered