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1386245710
JOHN EDWARD GOUGH
COLUMBIA, SC
NPI
1386245710
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2020-11-03
Last Update Date
2020-11-03
Business Address
JOHN EDWARD GOUGH MHP
2715 COLONIAL DR BLDG 200A
COLUMBIA, SC 29203-6818
Phone number: 803-898-4850
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Mailing Address
JOHN EDWARD GOUGH MHP
114 WATERVILLE DR
COLUMBIA, SC 29229-8141
Phone number: 803-865-8439
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