Provider Demographics
NPI:1053994574
Name:GOULD, INA (MS, MED)
Entity type:Individual
Prefix:
First Name:INA
Middle Name:
Last Name:GOULD
Suffix:
Gender:F
Credentials:MS, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PARK PLZ STE 106
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1399
Mailing Address - Country:US
Mailing Address - Phone:610-927-6593
Mailing Address - Fax:
Practice Address - Street 1:3 PARK PLZ STE 106
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1399
Practice Address - Country:US
Practice Address - Phone:610-927-6593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty