Individual
DR. PATRICIA ANN BLACK-GOULD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
10116 BITTERN DR # 32507, PENSACOLA, FL 32507-7208
(207) 890-5243
Mailing address
3298 SUMMIT BLVD, PENSACOLA, FL 32503-8318
(850) 860-0302
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
300905
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
SOCIAL SECURITY #
ME
Enumeration date
10/04/2006
Last updated
07/10/2020
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