Provider Demographics
NPI:1952122947
Name:GUILBEAU, AINSLEE REBEKAH (RD, LDN)
Entity type:Individual
Prefix:MRS
First Name:AINSLEE
Middle Name:REBEKAH
Last Name:GUILBEAU
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 VERNA ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-4431
Mailing Address - Country:US
Mailing Address - Phone:318-229-6180
Mailing Address - Fax:
Practice Address - Street 1:809 MARTIN LUTHER KING JR DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501-1884
Practice Address - Country:US
Practice Address - Phone:337-233-2437
Practice Address - Fax:337-233-7179
Is Sole Proprietor?:No
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3111133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered