Individual
SARA GRANDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
4420 IRVING BLVD NW, ALBUQUERQUE, NM 87114-5915
(505) 727-2790
Mailing address
4420 IRVING BLVD NW, ALBUQUERQUE, NM 87114-5915
(505) 727-2790
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LD2023054
NM LICENSE
NM
Enumeration date
01/06/2014
Last updated
02/19/2024
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