Healthcare Provider Details

I. General information

NPI: 1568258119
Provider Name (Legal Business Name): KAYLEE HOUGH RDN, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2025
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 HAMMOCK TRL E APT K115
FREEPORT FL
32439-7697
US

IV. Provider business mailing address

205 HAMMOCK TRL E APT K115
FREEPORT FL
32439-7697
US

V. Phone/Fax

Practice location:
  • Phone: 724-902-2221
  • Fax:
Mailing address:
  • Phone: 724-902-2221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD007011
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDX8195
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberND12883
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDT92024
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN010082
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: