Provider Demographics
NPI:1811360753
Name:DE VILLE DE GOYET, CAROLINE (IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:
Last Name:DE VILLE DE GOYET
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 1:14202 WOODVILLE GARDENS DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-1446
Mailing Address - Country:US
Mailing Address - Phone:832-419-2256
Mailing Address - Fax:
Practice Address - Street 1:14202 WOODVILLE GARDENS DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-1446
Practice Address - Country:US
Practice Address - Phone:832-419-2256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-31
Last Update Date:2015-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-88564174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN