Provider Demographics
NPI:1235937244
Name:LEONARD, JANELLE (MS, RD, LDN)
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:
Last Name:LEONARD
Suffix:
Gender:
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 ONEONTA ST
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-1624
Mailing Address - Country:US
Mailing Address - Phone:318-617-4095
Mailing Address - Fax:
Practice Address - Street 1:736 ONEONTA ST
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-1624
Practice Address - Country:US
Practice Address - Phone:318-617-4095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA86145396133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered