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Individual

MS. STACEY ELIZABETH SIMON

Active
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Individual

MS. STACEY ELIZABETH SIMON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86007711
NY
133V00000X
Registered Dietitian
DT88058
TX
133VN1101X
Gerontological Nutrition Registered Dietitian
86007711
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
86007711
REGISTERED DIETITIAN
Enumeration date
01/08/2014
Last updated
03/19/2026
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