Healthcare Provider Details

I. General information

NPI: 1669482840
Provider Name (Legal Business Name): LOIS M LENARD RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10701 EAST BLVD
CLEVELAND OH
44106-1702
US

IV. Provider business mailing address

6694 HIDDEN LAKE TRL
BRECKSVILLE OH
44141-3178
US

V. Phone/Fax

Practice location:
  • Phone: 216-791-3800
  • Fax: 216-421-3014
Mailing address:
  • Phone: 440-546-9129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD 3613
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: