Most Relevant Information
Provider Data
| NPI Number: | 1003068958 |
| Provider Name: | JACQUELINE AVA GOULD |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 0059001 |
Most Important Dates
| Enumeration Date: | 10/22/2008 |
| Last Updated: | 10/22/2008 |
Provider Practice Location
121 CREST DR
TARRYTOWN
NY
105914307
Practice Location Phone/Fax
| Phone: | 9146311185 |
| Fax: |
Provider Mailing Location
121 CREST DR
TARRYTOWN
NY
105914307
Provider Mailing Phone/Fax
| Phone: | 9146311185 |
| Fax: |