Provider Demographics
NPI:1336373455
Name:GOULD, VICTORIA MARIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:MARIE
Last Name:GOULD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 STEDMAN ST
Mailing Address - Street 2:
Mailing Address - City:KETCHIKAN
Mailing Address - State:AK
Mailing Address - Zip Code:99901-6632
Mailing Address - Country:US
Mailing Address - Phone:907-225-7825
Mailing Address - Fax:907-225-1541
Practice Address - Street 1:721 STEDMAN ST
Practice Address - Street 2:
Practice Address - City:KETCHIKAN
Practice Address - State:AK
Practice Address - Zip Code:99901-6632
Practice Address - Country:US
Practice Address - Phone:907-225-7825
Practice Address - Fax:907-225-1541
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-04
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001387101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional