Individual
TYLER JAMES GOULD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1 KENNEDY DR, SUITE U8, SOUTH BURLINGTON, VT 05403-7152
(802) 864-4513
(802) 878-1903
Mailing address
1 KENNEDY DR, SUITE U8, SOUTH BURLINGTON, VT 05403-7152
(802) 864-4513
(802) 878-1903
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
048-0000788
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007391
—
VT
01
—
28635
BLUE CROSS BLUE SHIELD VT
VT
Enumeration date
11/15/2006
Last updated
07/09/2007
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