Provider Demographics
NPI:1730635129
Name:POFF, KATY REBECCA-FRANKLIN (MS, RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:KATY
Middle Name:REBECCA-FRANKLIN
Last Name:POFF
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7008 INDIANA AVENUE, SUITE A
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79413
Mailing Address - Country:US
Mailing Address - Phone:806-698-8088
Mailing Address - Fax:
Practice Address - Street 1:7008 INDIANA AVENUE, SUITE A
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413
Practice Address - Country:US
Practice Address - Phone:806-698-8088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-26
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT84409133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered