Provider Demographics
NPI:1124255781
Name:SANDERSON, MEG (RD, LD)
Entity type:Individual
Prefix:MRS
First Name:MEG
Middle Name:
Last Name:SANDERSON
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1644 OLD CAHABA CT
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:AL
Mailing Address - Zip Code:35080-7054
Mailing Address - Country:US
Mailing Address - Phone:205-621-4133
Mailing Address - Fax:
Practice Address - Street 1:1644 OLD CAHABA CT
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:AL
Practice Address - Zip Code:35080-7054
Practice Address - Country:US
Practice Address - Phone:205-621-4133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-22
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1554133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education