Individual
JESSICA GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
919 W ZERR RD, GARDEN CITY, KS 67846-2777
(620) 640-3652
Mailing address
1605 W JULIE ST, GARDEN CITY, KS 67846-2621
(620) 640-3652
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-142304
KS
Other
Enumeration date
01/08/2019
Last updated
01/08/2019
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