Provider Demographics
NPI:1003017773
Name:GOULD, LINDA V (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:V
Last Name:GOULD
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 FOISY HILL RD
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03743-4325
Mailing Address - Country:US
Mailing Address - Phone:603-543-1972
Mailing Address - Fax:
Practice Address - Street 1:168 FOISY HILL RD
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:NH
Practice Address - Zip Code:03743-4325
Practice Address - Country:US
Practice Address - Phone:603-543-1972
Practice Address - Fax:603-542-4034
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0614235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30400154Medicaid