Organization
CKG PSYCH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CORIE GOULD PSY.D. (OWNER/LICENSED PSYCHOLOGIST)
(406) 698-2722
Entity
Organization
Contact information
Practice address
628 E PARENT AVE, SUITE 202, ROYAL OAK, MI 48067-3765
(510) 214-2544
Mailing address
628 E PARENT AVE, SUITE 202, ROYAL OAK, MI 48067-3765
(510) 214-2544
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301016590
MI
103TC2200X
Clinical Child & Adolescent Psychologist
6301016590
MI
Other
Enumeration date
11/01/2016
Last updated
11/01/2016
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