Healthcare Provider Details

I. General information

NPI: 1982986105
Provider Name (Legal Business Name): SARAH WILLIAMS RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2011
Last Update Date: 04/22/2020
Certification Date: 04/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 N FORBES BLVD STE 104
TUCSON AZ
85745-1446
US

IV. Provider business mailing address

2754 N CHERRY AVE
TUCSON AZ
85719-3128
US

V. Phone/Fax

Practice location:
  • Phone: 520-795-0111
  • Fax: 520-795-2332
Mailing address:
  • Phone: 801-913-2044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number998008
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: