Individual
STEFANIE RAE BROCKER
Active
Individual
STEFANIE RAE BROCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
DX4893
MD
133V00000X
Registered Dietitian
86043008
—
Other
Enumeration date
07/28/2023
Last updated
03/25/2025
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