Provider Demographics
NPI:1962205229
Name:WILSON, SARAH (HHP, BCHHC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:WILSON
Suffix:
Gender:
Credentials:HHP, BCHHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 FAIRACRES AVE
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-2028
Mailing Address - Country:US
Mailing Address - Phone:862-501-6575
Mailing Address - Fax:
Practice Address - Street 1:722 FAIRACRES AVE
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-2028
Practice Address - Country:US
Practice Address - Phone:862-501-6575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X
HI171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No133N00000XDietary & Nutritional Service ProvidersNutritionist