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General NPI Number Information
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NPI Number | 1407487135
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Entity Type | Individual
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Provider Name | JULIE ANN GOUGH FPS
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Gender | Female
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Dates
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Enumeration Date | 01/31/2020
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 323 MARION AVE NW STE 100
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City | MASSILLON
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State | OH
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Zip | 44646-3639
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Country | US
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Telephone | 330-493-3313
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Fax | 330-493-6413
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Provider Business Mailing Address
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Address Line | 323 MARION AVE NW STE 101
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City | MASSILLON
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State | OH
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Zip | 44646-3639
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Country | US
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Telephone | 330-737-2700
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Fax | 330-493-6413
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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