Provider Demographics
NPI:1831608603
Name:CLOKE, LESLEY ANN (RD)
Entity type:Individual
Prefix:MRS
First Name:LESLEY
Middle Name:ANN
Last Name:CLOKE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1895 BLUFF ST APT C
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-4286
Mailing Address - Country:US
Mailing Address - Phone:303-963-6479
Mailing Address - Fax:
Practice Address - Street 1:1895 BLUFF ST.
Practice Address - Street 2:UNIT C
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304
Practice Address - Country:US
Practice Address - Phone:303-963-6479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered