Individual
EDWIN BAKER GOODALL III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
401 GILFORD AVE, UNIT 103, GILFORD, NH 03249-7500
(603) 496-7955
(603) 528-2257
Mailing address
PO BOX 134, CENTER SANDWICH, NH 03227-0134
(603) 284-7174
(603) 528-2257
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
196
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0602256YONHO1
ANTHEM BCBS
NH
05
—
80622256
—
NH
Enumeration date
04/25/2007
Last updated
07/09/2007
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