Individual
REBECCA PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, CSP, LD
Contact information
Practice address
6161 S YALE AVE, TULSA, OK 74136-1902
(918) 494-2200
Mailing address
2853 E 35TH PL, TULSA, OK 74105-2927
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
801
OK
Other
Enumeration date
03/25/2020
Last updated
03/25/2020
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