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Individual

KAITLIN LICHTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2802 INTERNATIONAL CIR, COLORADO SPRINGS, CO 80910-3127
(719) 638-1223
Mailing address
1347 CYPRESS DR, EGLIN AFB, FL 32542-1458
(937) 694-9897

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD.08270
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NONE
NONE
Enumeration date
06/15/2022
Last updated
10/18/2023
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