Healthcare Provider Details

I. General information

NPI: 1316165780
Provider Name (Legal Business Name): SUNDIE GOULDING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37634 ENTERPRISE CT
FARMINGTON HILLS MI
48331-3440
US

IV. Provider business mailing address

1830 ANTIETAM ST
PITTSBURGH PA
15206-1124
US

V. Phone/Fax

Practice location:
  • Phone: 248-553-0902
  • Fax:
Mailing address:
  • Phone: 412-983-7795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: