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Contact Information

KIMBERLEE M MANGUIAT LANG
420 POLIFKA DR BLDG 1042
SHAW AFB, SC29152-5100
 Phone: 803-895-1216
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dietitian, Registered

133V00000X 71 Registered Dietitian or Nutrition Professional
 

Nutritionist

133N00000X
Indicates primary specialty

NPI Profile & details for KIMBERLEE M MANGUIAT LANG · (Female)

NPI # 1700997194
Status Active
Credentials
Entity Individual
Enumeration date 08/31/2006
Last updated 08/04/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • License # 813967
  • FL License # ND4052
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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