Provider Demographics
NPI:1609156124
Name:GOULD, TROY K
Entity Type:Individual
Prefix:MR
First Name:TROY
Middle Name:K
Last Name:GOULD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 SE COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-7207
Mailing Address - Country:US
Mailing Address - Phone:580-320-4387
Mailing Address - Fax:
Practice Address - Street 1:324 SE COUNTY RD
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-7207
Practice Address - Country:US
Practice Address - Phone:580-320-4387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor