Provider Demographics
NPI:1265987770
Name:BROWN, LEAH (MS, RDN, LDN)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10771
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19850-0771
Mailing Address - Country:US
Mailing Address - Phone:302-219-0777
Mailing Address - Fax:
Practice Address - Street 1:19 HIGHLAND BLVD APT A
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-6919
Practice Address - Country:US
Practice Address - Phone:302-219-0777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE0000575133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered