Provider Demographics
NPI:1972178069
Name:SARAH LEAHY NUTRITION LLC
Entity type:Organization
Organization Name:SARAH LEAHY NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:LEAHY
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:860-857-1902
Mailing Address - Street 1:PO BOX 7634
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060
Mailing Address - Country:US
Mailing Address - Phone:860-857-1902
Mailing Address - Fax:
Practice Address - Street 1:159 MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060
Practice Address - Country:US
Practice Address - Phone:860-857-1902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty