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General NPI Number Information
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NPI Number | 1841565041
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Entity Type | Individual
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Provider Name | KATELYN ENGEL RD
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Gender | Female
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Dates
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Enumeration Date | 03/20/2012
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Last Update Date | 03/20/2012
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Provider Practice Location Address
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Address Line | 4201 W VALHALLA BLVD APT 26
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City | SIOUX FALLS
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State | SD
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Zip | 57106-5232
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Country | US
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Telephone | 612-743-2340
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Fax |
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Provider Business Mailing Address
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Address Line | 4201 W VALHALLA BLVD APT 26
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City | SIOUX FALLS
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State | SD
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Zip | 57106-5232
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Country | US
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Telephone | 612-743-2340
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 0414
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 01069099
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License Number State |
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