Provider Demographics
NPI:1598585721
Name:LANGHALS, LISA MARIE (RDN, LD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:LANGHALS
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:OH
Mailing Address - Zip Code:45875-1105
Mailing Address - Country:US
Mailing Address - Phone:419-796-9641
Mailing Address - Fax:
Practice Address - Street 1:15054 E STATE ROUTE 224
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-9794
Practice Address - Country:US
Practice Address - Phone:419-427-3030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-14
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X
OH10066133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No174H00000XOther Service ProvidersHealth Educator