Individual
KATHRYN GOULD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
6415 W LAWRENCE LN, GLENDALE, AZ 85302-4457
(602) 524-9474
Mailing address
6415 W LAWRENCE LN, GLENDALE, AZ 85302-4457
(602) 524-9474
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
6726
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6726
COTA/L
AZ
Enumeration date
10/22/2016
Last updated
10/22/2016
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