Provider Demographics
NPI:1013037043
Name:GOUCHER, JUDY (OTRL, CHT)
Entity Type:Individual
Prefix:MS
First Name:JUDY
Middle Name:
Last Name:GOUCHER
Suffix:
Gender:F
Credentials:OTRL, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 863
Mailing Address - Street 2:
Mailing Address - City:TRINIDAD
Mailing Address - State:CA
Mailing Address - Zip Code:95570-0863
Mailing Address - Country:US
Mailing Address - Phone:707-677-0797
Mailing Address - Fax:707-442-0813
Practice Address - Street 1:3800 JANES RD
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-4742
Practice Address - Country:US
Practice Address - Phone:707-616-5777
Practice Address - Fax:707-839-5905
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA868225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand