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Individual
LESLEY GRADONE
Active
Individual
LESLEY GRADONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDN
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN006459
PA
133VN1004X
Pediatric Nutrition Registered Dietitian
DN006459
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103512598
—
PA
01
—
14277787
CAQH
—
Enumeration date
07/04/2018
Last updated
11/19/2020
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