Healthcare Provider Details
I. General information
NPI: 1578011425
Provider Name (Legal Business Name): KYLEIGH HARLOW MS, RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/20/2016
Last Update Date: 11/25/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
ARMY HEALTH CLINIC BLDG 2310, UNIT W1HH08
APO AE
09630
US
IV. Provider business mailing address
ARMY HEALTH CLINIC BLDG 2310, UNIT W1HH08
APO AE
09630
US
V. Phone/Fax
- Phone: 314-636-9402
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | DT85186 |
| License Number State | TX |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133VN1501X |
| Taxonomy | Sports Dietetics Nutrition Registered Dietitian |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: