Provider Demographics
NPI:1750901427
Name:GODFREY, SARAH LEVITRE (RDN)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:LEVITRE
Last Name:GODFREY
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:NAOMI
Other - Last Name:LEVITRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3624 PARTRIDGE PATH APT 3
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-2437
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3624 PARTRIDGE PATH APT 3
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-2437
Practice Address - Country:US
Practice Address - Phone:385-289-6921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI86114190133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered