Healthcare Provider Details

I. General information

NPI: 1750947727
Provider Name (Legal Business Name): LEAH RUTH KUHLMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2019
Last Update Date: 11/05/2020
Certification Date: 11/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

341 LEFFINGWELL AVE
SAINT LOUIS MO
63122-6409
US

IV. Provider business mailing address

341 LEFFINGWELL AVE
SAINT LOUIS MO
63122-6409
US

V. Phone/Fax

Practice location:
  • Phone: 636-219-5541
  • Fax:
Mailing address:
  • Phone: 636-219-5541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: