Individual
MISS ABRIELLE GOUVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
158 S BROAD ST, PAWCATUCK, CT 06379-1925
(860) 535-0440
Mailing address
1 WINTHROP AVE, PAWCATUCK, CT 06379-7919
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
005352
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47-5036384
ANTHEM BLUE CROSS BLUE SHIELD
CT
Enumeration date
03/18/2018
Last updated
03/18/2018
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