Doctor Name: | DR. MICHELE GOLDMAN |
NPI Number: | 1013376342 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D. |
License Number: | 0810005312 |
Business Practice Address: | 10460 Queens Blvd Apt 4z Forest Hills, NY - 113757318 |
Business Phone Number: | 9142635836 |
Business Fax Number: | |
Mailing Address: | 10460 Queens Blvd, Apt 4z FOREST HILLS |
State: | NY |
Postal Code: | 113757318 |
Phone Number: | 9142635836 |
Fax Number: | |
NPI Enumeration Date: | 02/15/2016 |
NPI Last Update Date: | 02/15/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 0810005312 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |