Individual
REBEKAH STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
409 N 6TH ST, LONGVIEW, TX 75601-6536
(903) 501-1747
Mailing address
PO BOX 2709, LONGVIEW, TX 75606-2709
(903) 234-0776
(903) 234-9769
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT84347
TX
Other
Enumeration date
10/29/2024
Last updated
10/29/2024
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