Provider Demographics
NPI:1770871170
Name:COLE, LEIGH LETTIERI (RD, LD)
Entity type:Individual
Prefix:
First Name:LEIGH
Middle Name:LETTIERI
Last Name:COLE
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:LEIGH
Other - Middle Name:LETTIERI
Other - Last Name:BRIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD
Mailing Address - Street 1:10030 WILLOW BROOK CIR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5354
Mailing Address - Country:US
Mailing Address - Phone:502-931-7617
Mailing Address - Fax:
Practice Address - Street 1:10030 WILLOW BROOK CIR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-5354
Practice Address - Country:US
Practice Address - Phone:502-931-7617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-19
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-0847133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered