Provider Demographics
NPI:1558528786
Name:ROLPH, REBECCA LEE (MS RD LDN)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:LEE
Last Name:ROLPH
Suffix:
Gender:F
Credentials:MS RD LDN
Other - Prefix:
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Mailing Address - Street 1:1035 W 39TH STREET
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-1333
Mailing Address - Country:US
Mailing Address - Phone:814-864-6333
Mailing Address - Fax:814-864-6333
Practice Address - Street 1:1510 STATE ST
Practice Address - Street 2:PERSEUS HOUSE
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16501-2220
Practice Address - Country:US
Practice Address - Phone:814-480-5900
Practice Address - Fax:814-456-4229
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PADN002001133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered