Individual
MS. DIANE GOULD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, BCBA
Contact information
Practice address
1866 SHERIDAN RD, HIGHLAND PARK, IL 60035-2547
(847) 917-5385
(847) 673-8593
Mailing address
1866 SHERIDAN RD, HIGHLAND PARK, IL 60035-2547
(847) 917-5385
(847) 673-8593
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1084352
IL
1041C0700X
Clinical Social Worker
Primary
149-002270
IL
Other
Enumeration date
01/04/2009
Last updated
01/04/2009
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