Healthcare Provider Details

I. General information

NPI: 1255103669
Provider Name (Legal Business Name): HEATHER LIEBER MS, RDN, CD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER STEELE MS, RDN, CD

II. Dates (important events)

Enumeration Date: 10/27/2023
Last Update Date: 10/27/2023
Certification Date: 10/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4878 S HIGHLAND CIR APT 2
SALT LAKE CITY UT
84117-6025
US

IV. Provider business mailing address

4878 S HIGHLAND CIR APT 2
SALT LAKE CITY UT
84117-6025
US

V. Phone/Fax

Practice location:
  • Phone: 801-529-8546
  • Fax:
Mailing address:
  • Phone: 801-529-8546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number11332957-4901
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: