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General NPI Number Information
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NPI Number | 1093986184
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Entity Type | Individual
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Provider Name | AUDREY GOLDMAN ED.D.
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Gender | Female
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Dates
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Enumeration Date | 03/17/2008
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Last Update Date | 04/14/2008
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Provider Practice Location Address
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Address Line | 1817 NORTH 7TH ST PHOENIX ELEMENTARY SCHOOL DISTRICT #1
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City | PHOENIX
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State | AZ
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Zip | 85006
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Country | US
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Telephone | 602-257-3755
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Fax |
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Provider Business Mailing Address
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Address Line | 13035 N. 48TH PL
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-3536
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Country | US
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Telephone | 602-762-7117
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State | AZ
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