Individual
MRS. HALEY RANAE GOULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10 HEALTH SERVICES DR, DEKALB, IL 60115-9600
(815) 756-5255
(815) 756-9944
Mailing address
10 HEALTH SERVICES DR, DEKALB, IL 60115-9600
(815) 756-5255
(815) 756-9944
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.003590
IL
Other
Enumeration date
10/19/2009
Last updated
03/12/2024
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