Provider Demographics
NPI:1023831088
Name:CARLSON, AMBER GOULD (RDN)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:GOULD
Last Name:CARLSON
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:GOULD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:7943 W PLYMOUTH PL
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-4422
Mailing Address - Country:US
Mailing Address - Phone:603-552-0520
Mailing Address - Fax:
Practice Address - Street 1:7943 W PLYMOUTH PL
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-4422
Practice Address - Country:US
Practice Address - Phone:603-552-0520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered