Provider Demographics
NPI:1407133812
Name:GUELIG, KIMBERLY L (IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:L
Last Name:GUELIG
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4819 CANAL DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-8161
Mailing Address - Country:US
Mailing Address - Phone:561-309-4314
Mailing Address - Fax:
Practice Address - Street 1:4819 CANAL DR
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-8161
Practice Address - Country:US
Practice Address - Phone:561-309-4314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
11173085174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN