Individual
HEATHER GOULD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
23 PORT ECHO LN, PALM COAST, FL 32164-6733
(386) 627-3148
Mailing address
23 PORT ECHO LN, PALM COAST, FL 32164-6733
(386) 627-3148
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 11868
FL
Other
Enumeration date
09/12/2011
Last updated
09/12/2011
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