Provider Demographics
NPI:1487195426
Name:SCHLOSBERG, REBECCA GABRIELLE (MS, RD, LDN)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:GABRIELLE
Last Name:SCHLOSBERG
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 POWDER HILL RD
Mailing Address - Street 2:
Mailing Address - City:BOLTON
Mailing Address - State:MA
Mailing Address - Zip Code:01740-1083
Mailing Address - Country:US
Mailing Address - Phone:847-477-0646
Mailing Address - Fax:
Practice Address - Street 1:40 POWDER HILL RD
Practice Address - Street 2:
Practice Address - City:BOLTON
Practice Address - State:MA
Practice Address - Zip Code:01740-1083
Practice Address - Country:US
Practice Address - Phone:847-477-0646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-09
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
MA4273133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered