Individual
MS. GAYLA M. GOUGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
11740 E 21ST ST, TULSA, OK 74129-1820
(918) 437-9495
Mailing address
1602 S PINE AVE, BROKEN ARROW, OK 74012-5211
(918) 852-9148
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2915
OK
Other
Enumeration date
08/06/2007
Last updated
08/27/2013
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