Provider Demographics
NPI:1235596032
Name:FINCH, REBEKAH (MA, RDN)
Entity Type:Individual
Prefix:MRS
First Name:REBEKAH
Middle Name:
Last Name:FINCH
Suffix:
Gender:F
Credentials:MA, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9921 DUPONT CIRCLE DRIVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825
Mailing Address - Country:US
Mailing Address - Phone:765-667-1355
Mailing Address - Fax:
Practice Address - Street 1:9921 DUPONT CIRCLE DR W
Practice Address - Street 2:SUITE 130
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-1614
Practice Address - Country:US
Practice Address - Phone:765-667-1355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-25
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN37002565A133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered