Provider Demographics
NPI:1164198586
Name:REBECCA THOMAS NUTRITION LLC.
Entity Type:Organization
Organization Name:REBECCA THOMAS NUTRITION LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN
Authorized Official - Phone:609-529-4897
Mailing Address - Street 1:1109 JADE DR
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-2428
Mailing Address - Country:US
Mailing Address - Phone:609-529-4897
Mailing Address - Fax:410-838-7065
Practice Address - Street 1:1109 JADE DR
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-2428
Practice Address - Country:US
Practice Address - Phone:609-529-4897
Practice Address - Fax:410-838-7065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty