| Doctor Name: | NANCY DEANE GOOD MADDOX |
| NPI Number: | 1790889475 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA LSPE |
| License Number: | SPE 1475 |
| Business Practice Address: | 6144 Cumberland Gap Parkway Suite 2 Harrogate, TN - 37752 |
| Business Phone Number: | 4236266352 |
| Business Fax Number: | |
| Mailing Address: | Po Box 1604, NEW TAZEWELL |
| State: | TN |
| Postal Code: | 378241604 |
| Phone Number: | 4236266352 |
| Fax Number: | |
| NPI Enumeration Date: | 09/12/2006 |
| NPI Last Update Date: | 01/09/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TH0100X |
| License Number: | SPE 1475 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974). |