Individual
MACKENZIE ERIN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,RDN, LDN, CDE
Contact information
Practice address
317 W LOCKHART ST, SAYRE, PA 18840-1618
(570) 887-3920
(570) 887-3035
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN005869
PA
Other
Enumeration date
04/13/2016
Last updated
02/26/2021
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