Mr. Michael W Goldberg
School Psychologist
113 Hawk Drive
Dulce
, New Mexico 87528
Mr. Michael W Goldberg
School Psychologist
113 Hawk Drive
Dulce
, New Mexico 87528
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About
Features
Specialties
- School Psychologist
Languages spoken
- English
Location
First Address
- Mr. Michael W Goldberg
- 98 Bull Elk Pl
- Pagosa Springs, CO
- Zip : 81147-8511
- Phone :
Second Address
- Mr. Michael W Goldberg
- 113 Hawk Drive
- Dulce, NM
- Zip : 87528
- Fax : (505) 759-1349
- Phone : (505) 759-2954
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103TS0200X | School Psychologist | 308194 | NM |
National Provider Identifier
| NPI | 1043340987 |
|---|---|
| Provider Name | Mr. Michael W Goldberg |
| First Address | Pagosa Springs, CO 81147-8511 |
| Second Address | Dulce, NM 87528 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/03/2007 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 27087859 | (05) | NM |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.