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Individual

AMBER M LEON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
1585 3RD ST, FORT POLK, LA 71459-5102
(619) 341-1636
Mailing address
1585 3RD ST, FORT POLK, LA 71459-5102

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
133V00000X
Registered Dietitian
Primary
DT85128
TX
136A00000X
Registered Dietetic Technician

Other

Enumeration date
08/27/2013
Last updated
10/25/2022
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