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General NPI Number Information
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NPI Number | 1720865231
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Entity Type | Individual
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Provider Name | RENEE MARIE GOULDING PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/11/2023
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 3421 GENTLE BREEZE DR STE A
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City | UPPER MARLBORO
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State | MD
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Zip | 20772-2549
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Country | US
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Telephone | 410-953-8506
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Fax |
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Provider Business Mailing Address
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Address Line | 121 KENT ST APT 1
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City | BLACK MOUNTAIN
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State | NC
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Zip | 28711-8747
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Country | US
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Telephone | 219-707-0262
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AC006973
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License Number State | MD
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