Individual
STEPHANIE KIM REZAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CDE
Contact information
Practice address
7410 S CREEK RD STE 100, SANDY, UT 84093-6151
(801) 816-1010
Mailing address
7410 S CREEK RD STE 100, SANDY, UT 84093-6151
(801) 816-1010
(801) 515-0045
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1114008-4901
UT
133V00000X
Registered Dietitian
35596DI-0
NV
Other
Enumeration date
06/17/2014
Last updated
02/03/2021
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