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Individual

LEAH BLACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RDN

Contact information

Practice address
2952 CONIFER CIRCLE, EVERGREEN, CO 80439
(210) 313-8272
Mailing address
2952 CONIFER CIRCLE, EVERGREEN, CO 80439

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86035907
CO

Other

Enumeration date
12/08/2016
Last updated
12/08/2016
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