Colleen Mathia Gould, IBCLC

Individual provider Active NPI Lactation Consultant (Non-RN) · Westwood, KS

NPI 1881179810 · NPPES record last updated Sep 25, 2018

Key facts

NPI
1881179810
Entity type
Individual (NPI type 1)
Primary specialty
Lactation Consultant (Non-RN) 174N00000X
License
L-17081 (KS)
Practice address
2700 W 47TH Ter
Westwood, KS 66205-1605
Phone
(816) 213-1417
NPI assigned
Sep 25, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
L-17081KSMDLactation Consultant (Non-RN)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Non-RN) 174N00000X L-17081 KS Yes

Addresses

Primary practice location

2700 W 47TH Ter
Westwood, KS 66205-1605

Mailing address

2700 W 47TH Ter
Westwood, KS 66205-1605

Other providers in Westwood, KS

All providers in Westwood, KS · Lactation Consultant (Non-RN) in Kansas

Sources for this page

Verify at the official NPI Registry.