Provider Demographics
NPI:1487173183
Name:HAUGH, REIKO MARGARETE (MS, RDN, LD)
Entity type:Individual
Prefix:MS
First Name:REIKO
Middle Name:MARGARETE
Last Name:HAUGH
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:MS
Other - First Name:REIKO
Other - Middle Name:MARGARETE
Other - Last Name:KOBAYASHI-WAGNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3345 W 95TH TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-2037
Mailing Address - Country:US
Mailing Address - Phone:425-367-1014
Mailing Address - Fax:
Practice Address - Street 1:3345 W 95TH TER
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-2037
Practice Address - Country:US
Practice Address - Phone:425-367-1014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-13
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL86005468133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered