Provider Demographics
NPI:1427540970
Name:BEX, DENEE LEIGH (REGISTERED DIETITIAN)
Entity Type:Individual
Prefix:
First Name:DENEE
Middle Name:LEIGH
Last Name:BEX
Suffix:
Gender:F
Credentials:REGISTERED DIETITIAN
Other - Prefix:
Other - First Name:DENEE
Other - Middle Name:LEIGH
Other - Last Name:YAZZIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3454
Mailing Address - Street 2:
Mailing Address - City:WINDOW ROCK
Mailing Address - State:AZ
Mailing Address - Zip Code:86515-3454
Mailing Address - Country:US
Mailing Address - Phone:602-550-6420
Mailing Address - Fax:
Practice Address - Street 1:CORNER OF ROUTES N12 & N7
Practice Address - Street 2:FDIHB
Practice Address - City:FORT DEFIANCE
Practice Address - State:AZ
Practice Address - Zip Code:86504
Practice Address - Country:US
Practice Address - Phone:928-729-8461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86096665133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered