Healthcare Provider Details

I. General information

NPI: 1417885625
Provider Name (Legal Business Name): LEAH GRACE PRICE MS, RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1137 FORT CONGAREE TRL APT 2016
CAYCE SC
29033-3739
US

IV. Provider business mailing address

1137 FORT CONGAREE TRL APT 2016
CAYCE SC
29033-3739
US

V. Phone/Fax

Practice location:
  • Phone: 772-834-3932
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2497
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: