Provider Demographics
NPI:1235379397
Name:TOUTANT, REBECCA MARIE (MA, RD, LDN)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:MARIE
Last Name:TOUTANT
Suffix:
Gender:F
Credentials:MA, RD, LDN
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:PANZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15 COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01721-1091
Mailing Address - Country:US
Mailing Address - Phone:781-530-4147
Mailing Address - Fax:
Practice Address - Street 1:25 WALNUT ST STE 300
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-2145
Practice Address - Country:US
Practice Address - Phone:781-530-4147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1123133V00000X
MA000002852133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered