Provider Demographics
NPI:1295724078
Name:GOSS, MOLLY MEGAN
Entity type:Individual
Prefix:MS
First Name:MOLLY
Middle Name:MEGAN
Last Name:GOSS
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 1:184 NASHUA ST
Mailing Address - Street 2:APT #4
Mailing Address - City:MILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03055-3747
Mailing Address - Country:US
Mailing Address - Phone:603-801-4255
Mailing Address - Fax:
Practice Address - Street 1:15 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3923
Practice Address - Country:US
Practice Address - Phone:603-889-6147
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor