Provider Demographics
NPI:1619782406
Name:SNOW, SARAH MARGARET MARY
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:MARGARET MARY
Last Name:SNOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:831 MITTEN RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-1324
Mailing Address - Country:US
Mailing Address - Phone:224-578-6610
Mailing Address - Fax:
Practice Address - Street 1:4929 FEAGAN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-7261
Practice Address - Country:US
Practice Address - Phone:224-578-6610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164007547133V00000X
FLND11359133V00000X
TXDT88258133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered