Provider Demographics
NPI:1992347975
Name:KLEIBER, LAURA ELIZABETH (MS, RDN, LDN)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ELIZABETH
Last Name:KLEIBER
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 BAUM BLVD # 306
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-3793
Mailing Address - Country:US
Mailing Address - Phone:412-593-2048
Mailing Address - Fax:844-311-7396
Practice Address - Street 1:5750 BAUM BLVD # 306
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-3793
Practice Address - Country:US
Practice Address - Phone:412-593-2048
Practice Address - Fax:844-311-7396
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN006904133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA104006678-0001Medicaid