Shawn Leask, | |
18 Campus Blvd Ste 100, Newtown Square, PA 19073-3240 | |
(215) 932-6789 | |
Not Available |
Full Name | Shawn Leask |
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Gender | Female |
Speciality | Dietitian, Registered |
Location | 18 Campus Blvd Ste 100, Newtown Square, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1205294246 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | DN004915 (Pennsylvania) | Primary |
Provider Name | Diamond Nutrition Counseling, Inc. |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1437794310 PECOS PAC ID: 0941637599 Enrollment ID: O20200402003098 |
Mailing Address | Practice Location Address |
---|---|
Shawn Leask, 18 Campus Blvd Ste 100, Newtown Square, PA 19073-3240 Ph: (215) 932-6789 | Shawn Leask, 18 Campus Blvd Ste 100, Newtown Square, PA 19073-3240 Ph: (215) 932-6789 |
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