Individual
MRS. LESLIE CLEM EDMUNDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPH, RD, LD
Contact information
Practice address
4359 E ENON RD, YELLOW SPRINGS, OH 45387-9708
(937) 206-1131
(937) 917-8048
Mailing address
4549 OLD MILL RD, SPRINGFIELD, OH 45502-9747
(937) 206-1131
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1013816
OH
133V00000X
Registered Dietitian
3262
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0166806
—
OH
Enumeration date
12/19/2011
Last updated
07/21/2022
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