Provider Demographics
NPI:1578011425
Name:HARLOW, KYLEIGH (MS, RD, LD)
Entity Type:Individual
Prefix:
First Name:KYLEIGH
Middle Name:
Last Name:HARLOW
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ARMY HEALTH CLINIC
Mailing Address - Street 2:BLDG 2310, UNIT W1HH08
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09630
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ARMY HEALTH CLINIC
Practice Address - Street 2:BLDG 2310, UNIT W1HH08
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09630
Practice Address - Country:US
Practice Address - Phone:314-636-9402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-20
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X, 133VN1501X
TXDT85186133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports Dietetics
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered