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NPI Code Detail

MEDICARE: MARY KATHRYN GOULD EDD, RDN, LD

MEDICARE: MARY KATHRYN GOULD EDD, RDN, LD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian324WV

General Provider Information

NPI Number : 1588509756
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY KATHRYN GOULD EDD, RDN, LD
Provider Business Mailing Address
First Line : 1 JOHN MARSHALL DR
Second Line :
City : HUNTINGTON
State : WV
Zip : 25755-0003
Country : US
Telephone Number : 304-696-3364
Fax Number :
Provider Business Practice Location Address
First Line : 1 JOHN MARSHALL DR
Second Line :
City : HUNTINGTON
State : WV
Zip : 25755-0003
Country : US
Telephone Number : 304-696-3364
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2026
Last Update Date : 04/22/2026

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