Provider Demographics
NPI:1699465047
Name:HAVOURD, SHARILONN (MS, CNS, LDN)
Entity type:Individual
Prefix:
First Name:SHARILONN
Middle Name:
Last Name:HAVOURD
Suffix:
Gender:F
Credentials:MS, CNS, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 E HOPKINS AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:ASPEN
Mailing Address - State:CO
Mailing Address - Zip Code:81611-2934
Mailing Address - Country:US
Mailing Address - Phone:970-309-0149
Mailing Address - Fax:855-754-1128
Practice Address - Street 1:600 E HOPKINS AVE STE 301
Practice Address - Street 2:
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-2934
Practice Address - Country:US
Practice Address - Phone:970-309-0149
Practice Address - Fax:855-754-1128
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX5545133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist