Provider Demographics
NPI:1760366371
Name:LAMOREUX, REBECCA ALEA (MS, RDN, LD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ALEA
Last Name:LAMOREUX
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15787
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87592-5787
Mailing Address - Country:US
Mailing Address - Phone:505-699-2615
Mailing Address - Fax:
Practice Address - Street 1:8 TRANQUIL TRL
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87508-4439
Practice Address - Country:US
Practice Address - Phone:505-699-2615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1331133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered