Individual
REBECCA L MONAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
520 E DOUGLAS BLVD, TYLER, TX 75702-8307
(903) 593-1721
Mailing address
PO BOX 5500, TYLER, TX 75712-5500
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT81427
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
215678801
—
TX
Enumeration date
05/18/2010
Last updated
05/12/2014
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