Individual
MRS. AMELIA C GOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
960 MCCOURTNEY RD, GRASS VALLEY, CA 95949-7422
(530) 470-3926
Mailing address
PO BOX 484, GRASS VALLEY, CA 95945-0484
(530) 470-3926
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
45734
CA
Other
Enumeration date
05/31/2012
Last updated
08/12/2013
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