Individual
SARA LAUREN PEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
411 OAK ST, ATTN: CREDENTIALS, CINCINNATI, OH 45219-2504
(513) 984-1800
(513) 984-4909
Mailing address
1614 CELIA DR, WICHITA FALLS, TX 76302-4130
(601) 720-3194
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
1063048
MS
133V00000X
Registered Dietitian
Primary
D1651
MS
Other
Enumeration date
04/07/2016
Last updated
04/23/2018
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