Individual
CAROLINE (KATE) GOURLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
13603 80TH CIR N, MAPLE GROVE, MN 55369-8961
(763) 274-3120
(763) 274-3121
Mailing address
13603 80TH CIR N, MAPLE GROVE, MN 55369-8961
(763) 274-3120
(763) 274-3121
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
19858
MN
Other
Enumeration date
02/11/2016
Last updated
02/11/2016
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