Healthcare Provider Details

I. General information

NPI: 1205395720
Provider Name (Legal Business Name): LAURIE ANN SAX RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2019
Last Update Date: 08/30/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDRENS PL DIV PED GASTRO, HEPATOLOGY AND NUTRITION
SAINT LOUIS MO
63110-1002
US

IV. Provider business mailing address

1 CHILDRENS PL MSC 8208-16-01
SAINT LOUIS MO
63110-1002
US

V. Phone/Fax

Practice location:
  • Phone: 314-454-6173
  • Fax: 844-231-8912
Mailing address:
  • Phone: 314-454-6173
  • Fax: 314-454-2412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number2013038522
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: