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General NPI Number Information
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NPI Number | 1861519530
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Entity Type | Individual
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Provider Name | GREGORY EVAN GOLDEN PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 08/30/2007
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Provider Practice Location Address
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Address Line | 6439 GARNERS FERRY RD
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City | COLUMBIA
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State | SC
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Zip | 29209-1638
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Country | US
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Telephone | 803-776-4000
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Fax | 803-695-6860
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Provider Business Mailing Address
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Address Line | 994 JEFFERY ST
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City | BOCA RATON
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State | FL
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Zip | 33487-4181
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Country | US
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Telephone | 561-445-6126
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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 | PY6265
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License Number State | FL
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