Provider Demographics
NPI:1962754259
Name:DRAEGER, SARAH JANE (RD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JANE
Last Name:DRAEGER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:388 GARDEN AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-8999
Mailing Address - Country:US
Mailing Address - Phone:616-393-0567
Mailing Address - Fax:616-393-0562
Practice Address - Street 1:388 GARDEN AVE STE 110
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-8999
Practice Address - Country:US
Practice Address - Phone:616-393-0567
Practice Address - Fax:616-393-0562
Is Sole Proprietor?:No
Enumeration Date:2012-10-10
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered