Individual
KA LIA VANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
W3985 COUNTRY ROAD NN, ELKHORN, WI 53121
(262) 741-2102
Mailing address
2012 S EAST AVE APT 19, WAUKESHA, WI 53189-2151
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
5018-29
WI
Other
Enumeration date
10/12/2022
Last updated
10/12/2022
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