Provider Demographics
NPI:1407170780
Name:BUTLER, ERICA LEIGH (RDN, LD)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:LEIGH
Last Name:BUTLER
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:LEIGH
Other - Last Name:DREWRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5202 BETHEL REED PARK STE 200
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-1818
Mailing Address - Country:US
Mailing Address - Phone:614-664-3646
Mailing Address - Fax:614-987-8654
Practice Address - Street 1:5202 BETHEL REED PARK STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-1818
Practice Address - Country:US
Practice Address - Phone:614-664-3646
Practice Address - Fax:614-987-8654
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-16
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL003480133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered