Individual
MISS MARLINE LOUISEDITH GOUSSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
42 S CENTER ST, FRACKVILLE, PA 17931-1647
(570) 593-5484
Mailing address
150 CHAMBERLAINE AVE, POTTSVILLE, PA 17901-8648
(570) 593-5484
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
224Z00000X
Occupational Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
11/08/2024
Last updated
11/08/2024
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