Provider Demographics
NPI:1770172496
Name:GOULD, HELEN
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:GOULD
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 1:1551 ILLINOIS RD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-4434
Mailing Address - Country:US
Mailing Address - Phone:727-238-3735
Mailing Address - Fax:
Practice Address - Street 1:1551 ILLINOIS RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-4434
Practice Address - Country:US
Practice Address - Phone:727-238-3735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-17
Last Update Date:2021-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No376K00000XNursing Service Related ProvidersNurse's Aide