Provider Demographics
NPI:1134843212
Name:SLANE, REBECCA (RD, LD)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:SLANE
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:MISS
Other - First Name:REBECCA
Other - Middle Name:JOY
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:189 STEVIE LN
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35186-5523
Mailing Address - Country:US
Mailing Address - Phone:205-914-3095
Mailing Address - Fax:
Practice Address - Street 1:189 STEVIE LN
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:AL
Practice Address - Zip Code:35186-5523
Practice Address - Country:US
Practice Address - Phone:205-914-3095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86176876133V00000X
AL3397133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered