Individual
TAMRA LYNN GOSSARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
140 UWAPO RD APT 48-105, KIHEI, HI 96753-7443
(480) 251-4042
Mailing address
140 UWAPO RD APT 48-105, KIHEI, HI 96753-7443
(480) 251-4042
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/10/2009
Last updated
02/09/2021
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