Provider Demographics
NPI:1851134399
Name:PERSON, REBECA HELEN (RD)
Entity type:Individual
Prefix:
First Name:REBECA
Middle Name:HELEN
Last Name:PERSON
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 BEAN OLLER RD
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-9222
Mailing Address - Country:US
Mailing Address - Phone:614-805-5539
Mailing Address - Fax:
Practice Address - Street 1:4800 BEAN OLLER RD
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-9222
Practice Address - Country:US
Practice Address - Phone:614-805-5539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1028064133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered