Individual
SARA MIRRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LDN
Contact information
Practice address
2872 TURNPIKE ST, SUSQUEHANNA, PA 18847-2771
(800) 323-2051
Mailing address
315 SHARON DR, PITTSTON, PA 18640-2298
(570) 675-0692
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN007366
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31087390
—
PA
Enumeration date
05/18/2021
Last updated
05/18/2021
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