Provider Demographics
NPI:1295010213
Name:GOUVEIA, TANYA (MA)
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:GOUVEIA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 FAUNCE CORNER RD UNIT 5
Mailing Address - Street 2:
Mailing Address - City:NORTH DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-6242
Mailing Address - Country:US
Mailing Address - Phone:774-201-9304
Mailing Address - Fax:508-763-9517
Practice Address - Street 1:360 FAUNCE CORNER RD UNIT 5
Practice Address - Street 2:
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-6242
Practice Address - Country:US
Practice Address - Phone:774-201-9304
Practice Address - Fax:508-763-9517
Is Sole Proprietor?:No
Enumeration Date:2011-10-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)