Individual
GABRIELLE GOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4858 PARETE CIR, JACKSONVILLE, FL 32218-1255
(860) 759-4828
Mailing address
4858 PARETE CIR, JACKSONVILLE, FL 32218-1255
(860) 759-4828
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW22223
FL
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046197938
—
MA
Enumeration date
06/10/2016
Last updated
11/25/2024
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