Provider Demographics
NPI:1720445612
Name:TRANTER, LESLIE FARRELL (MS, RD, LD, CDE)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:FARRELL
Last Name:TRANTER
Suffix:
Gender:F
Credentials:MS, RD, LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 NORTH DECATUR RD.
Mailing Address - Street 2:SUITE 0850
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033
Mailing Address - Country:US
Mailing Address - Phone:404-501-5967
Mailing Address - Fax:404-501-1773
Practice Address - Street 1:2701 NORTH DECATUR RD
Practice Address - Street 2:SUITE 0850 DEKALB MEDICAL
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033
Practice Address - Country:US
Practice Address - Phone:404-501-5967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-22
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD003849133N00000X, 133V00000X
GA21320330133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist