Doctor Name: | MRS. MARIA GOUDAS |
NPI Number: | 1083749808 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA LPCCS |
License Number: | 60002590 |
Business Practice Address: | 12557 Ravenwood Dr Ravenwood Mental Health Center Chardon, OH - 44024 |
Business Phone Number: | 4402853568 |
Business Fax Number: | |
Mailing Address: | 351 E Legend Ct, #f HIGHLAND HTS |
State: | OH |
Postal Code: | 44124 |
Phone Number: | 4404427871 |
Fax Number: | |
NPI Enumeration Date: | 02/22/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 60002590 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |