Provider Demographics
NPI:1902229586
Name:ATKINSON, SARAH (RD, CSR, LD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:RD, CSR, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 36714
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-0511
Mailing Address - Country:US
Mailing Address - Phone:803-280-8002
Mailing Address - Fax:888-414-8191
Practice Address - Street 1:2025 EBENEZER RD STE J4
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1079
Practice Address - Country:US
Practice Address - Phone:803-280-8002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-02
Last Update Date:2017-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC611133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal