Provider Demographics
NPI:1184488686
Name:OWEN, SARAH (RDN)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:OWEN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 ALLSTON CT
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN INN
Mailing Address - State:SC
Mailing Address - Zip Code:29644-6263
Mailing Address - Country:US
Mailing Address - Phone:518-598-7385
Mailing Address - Fax:
Practice Address - Street 1:102 ALLSTON CT
Practice Address - Street 2:
Practice Address - City:FOUNTAIN INN
Practice Address - State:SC
Practice Address - Zip Code:29644-6263
Practice Address - Country:US
Practice Address - Phone:518-598-7385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2439133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered