Provider Demographics
NPI:1639879026
Name:REBECCA SNOW NUTRITION, LLC
Entity Type:Organization
Organization Name:REBECCA SNOW NUTRITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, NUTRITIONIST
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SNOW
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CNS, LDN, RH
Authorized Official - Phone:443-840-7887
Mailing Address - Street 1:PO BOX 25
Mailing Address - Street 2:
Mailing Address - City:GLENELG
Mailing Address - State:MD
Mailing Address - Zip Code:21737-0025
Mailing Address - Country:US
Mailing Address - Phone:443-840-7887
Mailing Address - Fax:844-896-9941
Practice Address - Street 1:3509 REYNARD DR
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-1107
Practice Address - Country:US
Practice Address - Phone:443-840-7887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center