Individual
REBECCA ANTAYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, IBCLC
Contact information
Practice address
5503 ALBRIGHT AVE SW, WYOMING, MI 49418-9780
(616) 403-0786
Mailing address
5503 ALBRIGHT AVE SW, WYOMING, MI 49418-9780
(616) 403-0786
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
846899
MI
133V00000X
Registered Dietitian
846899
—
174N00000X
Lactation Consultant (Non-RN)
Primary
L-141903
—
Other
Enumeration date
08/14/2018
Last updated
03/11/2026
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