Provider Information for 1427794460
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MICHELLE GOSSARD LMHC
Sex: Female
NPI: 1427794460
Last Updated: 2022-05-11
Certification Date: 2022-05-11
Certification Date: 2022-05-11
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1427794460 | ||||||||
| Enumeration Date | 2022-05-11 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 214 7TH ST NE BONDURANT, IA 50035-4100 United States Phone: 515-954-0389 | Fax: | ||||||||
| Primary Practice Address | 214 7TH ST NE BONDURANT, IA 50035-4100 United States Phone: 515-954-0389 | Fax: | ||||||||
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