Provider Demographics
NPI:1598130411
Name:NORMANDEAU, REBECCA (RD, LD, CLC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:NORMANDEAU
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 1:8 MEADOWCREST RD
Mailing Address - Street 2:
Mailing Address - City:HOOKSETT
Mailing Address - State:NH
Mailing Address - Zip Code:03106-2621
Mailing Address - Country:US
Mailing Address - Phone:603-315-4577
Mailing Address - Fax:
Practice Address - Street 1:8 MEADOWCREST RD
Practice Address - Street 2:
Practice Address - City:HOOKSETT
Practice Address - State:NH
Practice Address - Zip Code:03106-2621
Practice Address - Country:US
Practice Address - Phone:603-315-4577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-03
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALDN4118133V00000X
MEDI1229133V00000X
NH0736133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered