Individual
RICHELLE R. LEIBOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D./L.D.
Contact information
Practice address
2701 E HILLS DR, MOORE, OK 73160-9542
(405) 799-9631
Mailing address
2701 E HILLS DR, MOORE, OK 73160
(405) 831-7426
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD773
OK
Other
Enumeration date
07/19/2011
Last updated
07/19/2011
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