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General NPI Number Information
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NPI Number | 1457757379
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Entity Type | Individual
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Provider Name | REGINA MARSHA GOULD MA,CCC-A
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Gender | Female
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Dates
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Enumeration Date | 11/05/2014
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Last Update Date | 08/06/2018
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Provider Practice Location Address
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Address Line | 4745 ARAPAHOE AVE STE 130
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City | BOULDER
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State | CO
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Zip | 80303
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Country | US
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Telephone | 303-443-2772
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Fax |
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Provider Business Mailing Address
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Address Line | 2285 CLAYTON CIR
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City | SUPERIOR
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State | CO
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Zip | 80027-8307
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Country | US
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Telephone | 720-290-5894
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Fax | 720-494-9555
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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 | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 145
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License Number State | CO
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