Provider Demographics
NPI:1063653368
Name:STONE, LEZLI R (RD)
Entity Type:Individual
Prefix:MRS
First Name:LEZLI
Middle Name:R
Last Name:STONE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5802 N 25TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-2842
Mailing Address - Country:US
Mailing Address - Phone:602-451-6873
Mailing Address - Fax:
Practice Address - Street 1:5802 N 25TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-2842
Practice Address - Country:US
Practice Address - Phone:602-451-6873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered