Individual
REBECCA MICHELLE SUDDOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,RD/LD,CSP
Contact information
Practice address
1200 N PHILLIPS AVE, SUITE 9500, OKLAHOMA CITY, OK 73104-4600
(405) 271-8001
(405) 271-7866
Mailing address
1200 N PHILLIPS AVE, SUITE 9500, OKLAHOMA CITY, OK 73104-4600
(405) 271-8001
(405) 271-7866
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
1105
OK
Other
Enumeration date
12/06/2010
Last updated
12/06/2010
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