Sally A Aday, R.D.

Individual provider Active NPI Registered Dietitian · San Carlos, AZ

NPI 1629109178 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1629109178
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
809443
Practice address
223 Cibeque Circle Road
San Carlos, AZ 85550-0208
Phone
(928) 475-2371
Fax
(928) 475-7370
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 809443 Yes

Addresses

Primary practice location

223 Cibeque Circle Road
San Carlos, AZ 85550-0208

Mailing address

PO Box 208
San Carlos, AZ 85550-0208
Phone (928) 475-2371

Other identifiers

IdentifierTypeStateIssuer
169194MedicaidAZ

Other providers in San Carlos, AZ

All providers in San Carlos, AZ · Registered Dietitian in Arizona

Sources for this page

Verify at the official NPI Registry.