Individual
MRS. TIMAREE HAGENBURGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, MPH, EP-C
Contact information
Practice address
550 HAZELWOOD DR, KISSIMMEE, FL 34744-4714
(209) 747-2195
Mailing address
550 HAZELWOOD DR, KISSIMMEE, FL 34744-4714
(209) 747-2195
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
865203
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
865203
COMMISSION ON DIETETIC REGISTRATION
—
Enumeration date
06/22/2018
Last updated
05/02/2022
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