Individual
DR. PETER GOULD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10615 JUDICIAL DR, 102, FAIRFAX, VA 22030-7501
(703) 346-0837
Mailing address
10615 JUDICIAL DR, 102, FAIRFAX, VA 22030-7501
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
0810003885
VA
103TC0700X
Clinical Psychologist
Primary
0810003885
VA
103TC2200X
Clinical Child & Adolescent Psychologist
0810003885
VA
Other
Enumeration date
05/08/2008
Last updated
05/07/2010
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