Individual
ALIA GOUCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11120 S CROWN WAY STE 1, WELLINGTON, FL 33414-8718
(561) 790-1191
Mailing address
1452 62ND AVE N, SAINT PETERSBURG, FL 33702-7336
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW15403
FL
Other
Enumeration date
08/08/2019
Last updated
08/08/2019
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