Provider Demographics
NPI:1871857706
Name:GOLD, DEBRA RACHEL
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:RACHEL
Last Name:GOLD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 ATLANTIC AVE
Mailing Address - Street 2:33H
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-6860
Mailing Address - Country:US
Mailing Address - Phone:508-769-7003
Mailing Address - Fax:
Practice Address - Street 1:145 FAUNCE CORNER RD
Practice Address - Street 2:SUITE K
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-1263
Practice Address - Country:US
Practice Address - Phone:774-206-1125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst