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Individual

DR. MARK A GOULD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH D

Contact information

Practice address
401 WEST THAMES STREET, SOUTHEASTERN MENTAL HEALTH AUTHORITY BLDG 301, NORWICH, CT 06360
(860) 859-4674
(860) 859-4790
Mailing address
401 WEST THAMES STREET, SOUTHEASTERN MENTAL HEALTH AUTHORITY BLDG 301, NORWICH, CT 06360
(860) 859-4674
(860) 859-4790

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
002277
CT

Other

Enumeration date
11/15/2006
Last updated
07/08/2007
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