Provider Demographics
NPI:1235503939
Name:SLABIC, RENEE F (RD)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:F
Last Name:SLABIC
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 1:3330 PEACH ST
Mailing Address - Street 2:SUITE 211
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508-2769
Mailing Address - Country:US
Mailing Address - Phone:814-877-5484
Mailing Address - Fax:814-877-5489
Practice Address - Street 1:3330 PEACH ST
Practice Address - Street 2:SUITE 211
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-2769
Practice Address - Country:US
Practice Address - Phone:814-877-5484
Practice Address - Fax:814-877-5489
Is Sole Proprietor?:No
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN002180133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered