Provider Demographics
NPI:1609399310
Name:LEHR, JENNIFER DAISY (RD, CD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:DAISY
Last Name:LEHR
Suffix:
Gender:F
Credentials:RD, CD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:D
Other - Last Name:RICHARDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:707 14TH ST
Mailing Address - Street 2:
Mailing Address - City:BARABOO
Mailing Address - State:WI
Mailing Address - Zip Code:53913-1539
Mailing Address - Country:US
Mailing Address - Phone:608-356-1586
Mailing Address - Fax:
Practice Address - Street 1:707 14TH ST.
Practice Address - Street 2:
Practice Address - City:BARABOO
Practice Address - State:WI
Practice Address - Zip Code:53913-1539
Practice Address - Country:US
Practice Address - Phone:608-356-1586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered