Most Relevant Information
Provider Data
| NPI Number: | 1003505769 |
| Provider Name: | LEANNA RENEE CLARK RDN |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 86116322 |
Most Important Dates
| Enumeration Date: | 05/08/2023 |
| Last Updated: | 05/08/2023 |
Provider Practice Location
321 HERBERTSVILLE ROAD, FIRST FLOOR
BRICK
NJ
08724
Practice Location Phone/Fax
| Phone: | 7327097730 |
| Fax: |
Provider Mailing Location
912 PARK PLACE
RED BANK
NJ
07701
Provider Mailing Phone/Fax
| Phone: | 9086753316 |
| Fax: |