Individual
REBEKAH JAYNE DEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
116 JUPITER CT, INDIALANTIC, FL 32903-2103
(408) 410-8275
Mailing address
116 JUPITER CT, INDIALANTIC, FL 32903-2103
(408) 410-8275
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86115281
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86115281
COMMISSION ON DIETETIC REGISTRATION
—
01
—
9321
FLORIDA STATE DIETITIAN/NUTRITIONIST LICENSE
FL
Enumeration date
11/12/2020
Last updated
11/12/2020
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