Individual
LESLIE HUMPHREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, RD/LDN, CLC
Contact information
Practice address
86720 SHORTLINE CIR, YULEE, FL 32097-0107
(904) 572-9716
Mailing address
86720 SHORTLINE CIR, YULEE, FL 32097-0107
(904) 572-9716
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
11344
FL
Other
Enumeration date
11/08/2024
Last updated
11/08/2024
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