Provider Demographics
NPI:1861844490
Name:LEIKIN, HANNA JULIA (MS, RD, CSP, LD)
Entity Type:Individual
Prefix:MRS
First Name:HANNA
Middle Name:JULIA
Last Name:LEIKIN
Suffix:
Gender:F
Credentials:MS, RD, CSP, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 MAYFIELD RD STE 200
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2207
Mailing Address - Country:US
Mailing Address - Phone:440-312-9706
Mailing Address - Fax:
Practice Address - Street 1:6801 MAYFIELD RD STE 200
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44124-2270
Practice Address - Country:US
Practice Address - Phone:440-312-9706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-07
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7982133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0196462Medicaid