Provider Demographics
NPI:1932676335
Name:HAVERLAND, SARAH CRAIG (RD, LDN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:CRAIG
Last Name:HAVERLAND
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3112 PINEHURST PL
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-3102
Mailing Address - Country:US
Mailing Address - Phone:336-689-5764
Mailing Address - Fax:
Practice Address - Street 1:1717 SHARON RD W
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-5663
Practice Address - Country:US
Practice Address - Phone:980-859-2133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL005196133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered