Individual
MR. MARK A GONSALVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC 1
Contact information
Practice address
200 TER HEUN DR, FALMOUTH, MA 02540-2525
(508) 540-6550
(508) 540-7480
Mailing address
15 OAK ST, NEW BEDFORD, MA 02740-3343
(508) 992-3369
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1531
MA
Other
Enumeration date
04/26/2007
Last updated
07/08/2007
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