| Doctor Name: | BETTY S GOSNELL |
| NPI Number: | 1497893507 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LMFT, LPC |
| License Number: | 0718000081 |
| Business Practice Address: | 4448 Germanna Hwy Ste 7c Locust Grove, VA - 225082012 |
| Business Phone Number: | 5409720505 |
| Business Fax Number: | 5409720500 |
| Mailing Address: | Po Box 386, LOCUST GROVE |
| State: | VA |
| Postal Code: | 225080386 |
| Phone Number: | 5409720504 |
| Fax Number: | 5409720500 |
| NPI Enumeration Date: | 02/01/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 0718000081 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |