| Doctor Name: | MR. TOMMY MCGOLDRICK |
| NPI Number: | 1528248531 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMHC |
| License Number: | 0108901 |
| Business Practice Address: | 6621 Doniphan Dr Ste G Canutillo, TX - 798355005 |
| Business Phone Number: | 9158775100 |
| Business Fax Number: | 9158775107 |
| Mailing Address: | 6621 Doniphan Dr Ste G, CANUTILLO |
| State: | TX |
| Postal Code: | 798355005 |
| Phone Number: | 9158775100 |
| Fax Number: | 9158775107 |
| NPI Enumeration Date: | 11/07/2007 |
| NPI Last Update Date: | 11/07/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 0108901 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |