Individual
LEAH A TEAGUE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
409 S 2ND ST, SUITE 3F, HARRISBURG, PA 17104-1612
(717) 230-3459
(717) 230-3411
Mailing address
111 S FRONT ST, HARRISBURG, PA 17101-2010
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN000454
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN000454
LICENSE
PA
Enumeration date
06/13/2006
Last updated
07/08/2007
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