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General NPI Number Information
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NPI Number | 1093402851
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Entity Type | Individual
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Provider Name | REBECCA CHARBONNEAU RD
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Gender | Female
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Dates
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Enumeration Date | 04/21/2023
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 418 HARRIS ST STE 324
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City | JUNEAU
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State | AK
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Zip | 99801-1078
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Country | US
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Telephone | 907-921-3748
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Fax |
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Provider Business Mailing Address
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Address Line | 4450 MOUNTAINSIDE DR
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City | JUNEAU
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State | AK
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Zip | 99801-9560
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Country | US
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Telephone | 567-208-8394
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 138808
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License Number State | AK
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