Individual
MS. SUZANNAH MIRIAM GOULD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADAC
Contact information
Practice address
HWY 491 NORTH PINION STREET, SHIPROCK, NM 87420
(505) 368-1050
(505) 368-1437
Mailing address
PO BOX 1830, SHIPROCK, NM 87420-1830
(505) 368-1050
(505) 368-1437
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4441
NM
Other
Enumeration date
07/31/2008
Last updated
07/12/2019
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