Provider Demographics
NPI:1750649646
Name:REASONS, REBECCA L
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:L
Last Name:REASONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 EASTMORELAND AVE
Mailing Address - Street 2:SUITE 335
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-3519
Mailing Address - Country:US
Mailing Address - Phone:901-726-1199
Mailing Address - Fax:901-726-0794
Practice Address - Street 1:1325 EASTMORELAND AVE
Practice Address - Street 2:SUITE 335
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3519
Practice Address - Country:US
Practice Address - Phone:901-726-1199
Practice Address - Fax:901-726-0794
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-27
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2310133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal