MEDICARE: MS. GILLIAN G FOREMAN MA, IBCLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number
1	174400000X	Specialist
2	174H00000X	Health Educator
3	374J00000X	Doula
4	174N00000X	Lactation Consultant (Non-RN)	L-310591

General Provider Information

NPI Number	:	1164709549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GILLIAN G FOREMAN MA, IBCLC

Provider Business Mailing Address
First Line	:	1719 STOCKTON DR
Second Line	:
City	:	LOVELAND
State	:	OH
Zip	:	45140-2025
Country	:	US
Telephone Number	:	214-208-5535
Fax Number	:

Provider Business Practice Location Address
First Line	:	5011 KENWOOD RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45227-2040
Country	:	US
Telephone Number	:	214-208-5535
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2011
Last Update Date	:	06/19/2023

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