Individual
MISS JESSIE GOULD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13 THOMPSON HAY PATH, SETAUKET, NY 11733-1317
(631) 751-0197
Mailing address
212 SPIRAL RD, HOLTSVILLE, NY 11742-2242
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/28/2014
Last updated
01/28/2014
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