Individual
MR. ROBERT MACY GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., M.S.
Contact information
Practice address
35 TIMBER LN, SOUTH BURLINGTON, VT 05403-5201
(802) 651-7562
(802) 860-3613
Mailing address
320 LOST NATION RD, ESSEX JUNCTION, VT 05452-2428
(802) 879-0439
(802) 860-3613
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
047-0000429
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002609
—
VT
Enumeration date
10/06/2006
Last updated
07/09/2007
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