Provider Demographics
NPI:1750447793
Name:GOL, JOANNA (PHD)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:GOL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 NORFOLK ST
Mailing Address - Street 2:#505
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-4096
Mailing Address - Country:US
Mailing Address - Phone:713-520-0482
Mailing Address - Fax:713-622-1999
Practice Address - Street 1:2211 NORFOLK ST
Practice Address - Street 2:#505
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-4096
Practice Address - Country:US
Practice Address - Phone:713-520-0482
Practice Address - Fax:713-622-1999
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25606103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent