Provider Demographics
NPI:1326321894
Name:BILBY, REBECCA A (RD, LD, CLC)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:A
Last Name:BILBY
Suffix:
Gender:F
Credentials:RD, LD, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2316 US HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:OH
Mailing Address - Zip Code:45103-8609
Mailing Address - Country:US
Mailing Address - Phone:513-532-8514
Mailing Address - Fax:
Practice Address - Street 1:2316 US HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:OH
Practice Address - Zip Code:45103-8609
Practice Address - Country:US
Practice Address - Phone:513-532-8514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5673133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered