Individual
MS. JEANNIE MARIE LEITAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2790 MAIN ST, GLASTONBURY, CT 06033-2027
(860) 430-9922
(860) 633-9922
Mailing address
2790 MAIN ST, GLASTONBURY, CT 06033-2027
(860) 430-9922
(860) 633-9922
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
133V00000X
Registered Dietitian
Primary
000964
CT
Other
Enumeration date
12/15/2009
Last updated
03/11/2019
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