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Individual

SUE MCGOUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
452 W MARKET ST, XENIA, OH 45385-2815
(937) 376-8700
(937) 376-8725
Mailing address
452 W MARKET ST, XENIA, OH 45385-2815
(937) 376-8700
(937) 376-8725

Taxonomy

Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
RN268380
OH
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
RN268380
OH
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN.268380
OH

Other

Enumeration date
03/20/2012
Last updated
03/25/2013
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