Healthcare Provider Details

I. General information

NPI: 1730682923
Provider Name (Legal Business Name): SARAH HALL RD, LD, CNSC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2018
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3018 CARDINAL DR
AUGUSTA GA
30909-3040
US

IV. Provider business mailing address

3018 CARDINAL DR
AUGUSTA GA
30909-3040
US

V. Phone/Fax

Practice location:
  • Phone: 540-250-0276
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1286
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number1286
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: