Provider Demographics
NPI:1952450777
Name:LEIGH, TWYLA ROSE (RD)
Entity Type:Individual
Prefix:
First Name:TWYLA
Middle Name:ROSE
Last Name:LEIGH
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 1:9931 BOCA CIR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-7315
Mailing Address - Country:US
Mailing Address - Phone:239-272-9770
Mailing Address - Fax:239-377-0281
Practice Address - Street 1:5775 OSCEOLA TRL
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-0919
Practice Address - Country:US
Practice Address - Phone:239-377-0296
Practice Address - Fax:239-377-0281
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0000576133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered