Organization
ICT LACTATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELISABETH GOEBEL RN, IBCLC (OWNER)
(316) 680-8917
Entity
Organization
Contact information
Practice address
123 N TYLER RD STE 100, WICHITA, KS 67212-3726
(316) 202-8264
Mailing address
11804 W SHERIAC ST, WICHITA, KS 67209-4086
(316) 680-8917
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1306403209
NPI
KS
Enumeration date
12/18/2023
Last updated
12/18/2023
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