Sally A Goforth
Psychologist
1500 Dodson Ave Ste240
Fort Smith
, Arkansas 72901-5182
Sally A Goforth
Psychologist
1500 Dodson Ave Ste240
Fort Smith
, Arkansas 72901-5182
(479) 709-7053
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About
Features
Specialties
- Psychologist
Languages spoken
- English
Location
First Address
- Sally A Goforth
- Po Box 402330
- Atlanta, GA
- Zip : 30384-2330
- Fax : (479) 709-7053
- Phone : (479) 709-7399
Second Address
- Sally A Goforth
- 1500 Dodson Ave Ste240
- Fort Smith, AR
- Zip : 72901-5182
- Fax : (479) 709-7456
- Phone : (479) 709-7455
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FAQs
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Is Sally A Goforth a sole practitioner?
Is Sally A Goforth accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 102L00000X | Psychologist | 785P | AR |
| Y | 103T00000X | Psychologist | 785P | AR |
National Provider Identifier
| NPI | 1013904978 |
|---|---|
| Provider Name | Sally A Goforth |
| First Address | Atlanta, GA 30384-2330 |
| Second Address | Fort Smith, AR 72901-5182 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/10/2005 |
| Last Update Date | 13/08/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 100838720A | (05) | OK |
| 119900719 | (05) | AR |
| R01955 | (02) | AR |
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.