Healthcare Provider Details

I. General information

NPI: 1316623010
Provider Name (Legal Business Name): SARAH LYNN ANDERSON RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 BELMONT ST
WORCESTER MA
01604-1019
US

IV. Provider business mailing address

401 ENGAMORE LN APT 107
NORWOOD MA
02062-2556
US

V. Phone/Fax

Practice location:
  • Phone: 508-856-0104
  • Fax:
Mailing address:
  • Phone: 860-503-9250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLDN6066
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: