Individual
KAYLA THORNGATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, IBCLC
Contact information
Practice address
16 SUNLIGHT LN, BAILEY, CO 80421-2300
(970) 673-7103
Mailing address
16 SUNLIGHT LN, BAILEY, CO 80421-2300
(970) 673-7103
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1107967
CO
174N00000X
Lactation Consultant (Non-RN)
L-150011
CO
Other
Enumeration date
10/25/2016
Last updated
04/14/2022
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