Individual
ANGELA KASBOHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.D.
Contact information
Practice address
2115 PARKVIEW DR, EL RENO, OK 73036-2109
(405) 262-2640
(405) 422-2521
Mailing address
2115 PARKVIEW DR, EL RENO, OK 73036-2109
(405) 262-2640
(405) 422-2521
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1068
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1068
LD LICENSE
OK
Enumeration date
10/17/2006
Last updated
10/27/2011
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