Provider Demographics
NPI:1780252049
Name:DEEM, LINDSAY LEEANNE (RD, LD, CNSC)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:LEEANNE
Last Name:DEEM
Suffix:
Gender:F
Credentials:RD, LD, CNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2303 BOLIVAR ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-1896
Mailing Address - Country:US
Mailing Address - Phone:214-762-2278
Mailing Address - Fax:
Practice Address - Street 1:2303 BOLIVAR ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-1896
Practice Address - Country:US
Practice Address - Phone:214-762-2278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT81744133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered