Healthcare Provider Details

I. General information

NPI: 1609780642
Provider Name (Legal Business Name): LEIGH ANNE SLIWINSKI RDN/LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6487 LYNLEIGH CIR NW
CANTON OH
44708-1187
US

IV. Provider business mailing address

6487 LYNLEIGH CIR NW
CANTON OH
44708-1187
US

V. Phone/Fax

Practice location:
  • Phone: 330-323-3584
  • Fax:
Mailing address:
  • Phone: 330-323-3584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1101X
TaxonomyGerontological Nutrition Registered Dietitian
License NumberLD.4053
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: