Provider Demographics
NPI:1679372767
Name:TROFATTER, SARAH ROSE (RD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ROSE
Last Name:TROFATTER
Suffix:
Gender:
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1324 TUTTLE RD
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:MI
Mailing Address - Zip Code:48854-8703
Mailing Address - Country:US
Mailing Address - Phone:517-342-4322
Mailing Address - Fax:
Practice Address - Street 1:1324 TUTTLE RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:MI
Practice Address - Zip Code:48854-8703
Practice Address - Country:US
Practice Address - Phone:517-285-6317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI979591133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered