Individual
SARAH JANE MIRACLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN,LD
Contact information
Practice address
409 S 14TH PL, ADA, OK 74820-7137
(580) 421-5970
Mailing address
409 S 14TH PL, ADA, OK 74820-7137
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
470
OK
Other
Enumeration date
06/03/2017
Last updated
06/03/2017
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