Basic Information
| Provider Information | |||||||||
| NPI: | 1356860605 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COX | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | SERENITY | ||||||||
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| Credential: | CN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1485 SCENIC HWY N | ||||||||
| Address2: | |||||||||
| City: | SNELLVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300782212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4703318545 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3400C OLD MILTON PKWY STE 270 | ||||||||
| Address2: | |||||||||
| City: | ALPHARETTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300054438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7704421911 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/18/2017 | ||||||||
| LastUpdateDate: | 09/18/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133NN1002X | Y | Dietary & Nutritional Service Providers | Nutritionist | Nutrition, Education |
No ID Information.