Provider Demographics
NPI:1518313576
Name:PRINGLE, KALIA (HAIR LOSS SPECIALIST)
Entity Type:Individual
Prefix:
First Name:KALIA
Middle Name:
Last Name:PRINGLE
Suffix:
Gender:F
Credentials:HAIR LOSS SPECIALIST
Other - Prefix:
Other - First Name:KALIA
Other - Middle Name:
Other - Last Name:PRINGLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:HAIR LOSS SPECIALIST
Mailing Address - Street 1:818 VANCE RD
Mailing Address - Street 2:
Mailing Address - City:VANCE
Mailing Address - State:SC
Mailing Address - Zip Code:29163-9348
Mailing Address - Country:US
Mailing Address - Phone:843-617-7817
Mailing Address - Fax:
Practice Address - Street 1:818 VANCE RD
Practice Address - Street 2:
Practice Address - City:VANCE
Practice Address - State:SC
Practice Address - Zip Code:29163-9348
Practice Address - Country:US
Practice Address - Phone:843-617-7817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management