Healthcare Provider Details

I. General information

NPI: 1457543704
Provider Name (Legal Business Name): SARA SAVANAH HARDIN M.A., R.D., C.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2007
Last Update Date: 08/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N STATE ST
GREENFIELD IN
46140-1270
US

IV. Provider business mailing address

801 N STATE ST
GREENFIELD IN
46140-1270
US

V. Phone/Fax

Practice location:
  • Phone: 317-468-4880
  • Fax: 317-468-4822
Mailing address:
  • Phone: 317-468-4880
  • Fax: 317-468-4822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number958685
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: