Provider Demographics
NPI:1295064871
Name:STETZER, REBECCA (RD, CD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:STETZER
Suffix:
Gender:F
Credentials:RD, CD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:HADLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:N10733 TIMBERWOLF LN
Mailing Address - Street 2:
Mailing Address - City:TREMPEALEAU
Mailing Address - State:WI
Mailing Address - Zip Code:54661-9308
Mailing Address - Country:US
Mailing Address - Phone:608-799-2608
Mailing Address - Fax:
Practice Address - Street 1:N10733 TIMBERWOLF LN
Practice Address - Street 2:
Practice Address - City:TREMPEALEAU
Practice Address - State:WI
Practice Address - Zip Code:54661-9308
Practice Address - Country:US
Practice Address - Phone:608-799-2608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-10
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2226-029133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered