Provider Demographics
NPI:1134522873
Name:SARLE, ELIZABETH MOREAU (RD,LD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MOREAU
Last Name:SARLE
Suffix:
Gender:F
Credentials:RD,LD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:MOREAU
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD
Mailing Address - Street 1:420 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:RUMFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04276-2104
Mailing Address - Country:US
Mailing Address - Phone:207-369-1000
Mailing Address - Fax:207-369-1182
Practice Address - Street 1:420 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:RUMFORD
Practice Address - State:ME
Practice Address - Zip Code:04276-2104
Practice Address - Country:US
Practice Address - Phone:207-369-1000
Practice Address - Fax:207-369-1182
Is Sole Proprietor?:No
Enumeration Date:2014-10-08
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
METD1217133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered