Provider Demographics
NPI:1629874490
Name:YENCHIK, REBECCA (CNC, CMH, HTMAP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:YENCHIK
Suffix:
Gender:F
Credentials:CNC, CMH, HTMAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 TRACY BREWER RD
Mailing Address - Street 2:
Mailing Address - City:MESHOPPEN
Mailing Address - State:PA
Mailing Address - Zip Code:18630-8153
Mailing Address - Country:US
Mailing Address - Phone:570-721-3044
Mailing Address - Fax:
Practice Address - Street 1:191 TRACY BREWER RD
Practice Address - Street 2:
Practice Address - City:MESHOPPEN
Practice Address - State:PA
Practice Address - Zip Code:18630-8153
Practice Address - Country:US
Practice Address - Phone:570-721-3044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist