Healthcare Provider Details

I. General information

NPI: 1992837389
Provider Name (Legal Business Name): SARA GRAVES LDN, RD60
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 09/29/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 BELMONT ST
WORCESTER MA
01605-2903
US

IV. Provider business mailing address

15 FOXHILL RD
SHREWSBURY MA
01545-1926
US

V. Phone/Fax

Practice location:
  • Phone: 508-334-6656
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1353
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: