Provider Demographics
NPI:1992490296
Name:LEAFE NUTRITION PLLC
Entity type:Organization
Organization Name:LEAFE NUTRITION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:MISS
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:JOSEPHINE
Authorized Official - Last Name:BARRERA
Authorized Official - Suffix:
Authorized Official - Credentials:MPH, RDN
Authorized Official - Phone:520-425-9698
Mailing Address - Street 1:16601 N 12TH ST APT 1142
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-7716
Mailing Address - Country:US
Mailing Address - Phone:520-425-9698
Mailing Address - Fax:
Practice Address - Street 1:16601 N 12TH ST APT 1142
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-7716
Practice Address - Country:US
Practice Address - Phone:520-425-9698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty