Individual
NICOLE SAMANTHA SARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3225 LAKE AVE, ASHTABULA, OH 44004-5758
(440) 998-7515
(440) 998-0973
Mailing address
3225 LAKE AVE, ASHTABULA, OH 44004-5758
(440) 998-7515
(440) 998-0973
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1049341
IL
133V00000X
Registered Dietitian
LD.6996
OH
Other
Enumeration date
12/06/2018
Last updated
12/06/2018
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