Individual
DR. HENRY J. GOETZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
100 W. BEAVER CREEK BLVD, SUITE 218, AVON, CO 81620-8572
(845) 594-4692
(845) 471-1815
Mailing address
PO BOX 8572, 100 W. BEAVER CREEK BLVD, SUITE 218, AVON, CO 81620-8572
(845) 594-4692
(845) 471-1815
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
007274
NY
103TC0700X
Clinical Psychologist
Primary
3047
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-0592394
TAX ID
—
Enumeration date
07/27/2006
Last updated
11/13/2008
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