Individual
BRIANNE DEWITT GOUDELOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9650 ZELZAH AVE, NORTHRIDGE, CA 91325-2003
(818) 993-9311
Mailing address
9650 ZELZAH AVE, NORTHRIDGE, CA 91325-2003
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/21/2007
Last updated
08/21/2007
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