Provider Demographics
NPI:1659084739
Name:GOLMAN, LIVA (CLC)
Entity Type:Individual
Prefix:MRS
First Name:LIVA
Middle Name:
Last Name:GOLMAN
Suffix:
Gender:F
Credentials:CLC
Other - Prefix:MRS
Other - First Name:LIBA
Other - Middle Name:
Other - Last Name:GOLMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CLC
Mailing Address - Street 1:612 WINONA CT
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-3265
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:612 WINONA CT
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-3265
Practice Address - Country:US
Practice Address - Phone:916-835-9225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD335940174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN