Provider Demographics
NPI:1023753597
Name:DENTI, LEISA (HEALTH AND WELLNESS)
Entity type:Individual
Prefix:
First Name:LEISA
Middle Name:
Last Name:DENTI
Suffix:
Gender:F
Credentials:HEALTH AND WELLNESS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 780
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28786-0780
Mailing Address - Country:US
Mailing Address - Phone:828-550-6814
Mailing Address - Fax:828-800-9920
Practice Address - Street 1:525 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-3817
Practice Address - Country:US
Practice Address - Phone:828-550-6814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach