Provider Demographics
NPI:1093336133
Name:LIEBCHEN, VERONICA (RD, LD)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:LIEBCHEN
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14527 BENNINGTON DR
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-8107
Mailing Address - Country:US
Mailing Address - Phone:440-570-7142
Mailing Address - Fax:
Practice Address - Street 1:14527 BENNINGTON DR
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-8107
Practice Address - Country:US
Practice Address - Phone:440-570-7142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7459133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered