Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 02360 | MD |
Y | 103G00000X | Clinical Psychologist | 02360 | MD |
Y | 103TC0700X | Clinical Psychologist | 02360 | MD |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 02360 | MD |
N | 103TF0000X | Family Psychologist | 02360 | MD |
NPI | 1093952509 |
---|---|
Provider Name | Dr. Gail H Goldberg |
First Address | Baltimore, MD 21204-6819 |
Second Address | Baltimore, MD 21204-6819 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2009 |
Last Update Date | 13/05/2009 |