Individual
RENEE GOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4255 MEDWEL DR, NEWBURGH, IN 47630-2528
(812) 853-2993
Mailing address
6222 SUMMIT POINTE WAY, NEWBURGH, IN 47630-2079
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31004106A
IN
Other
Enumeration date
06/29/2007
Last updated
07/08/2007
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