Individual
KENNETH J GOLDBERG
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ED.D
Contact information
Practice address
600 E BASELINE RD, SUITE C-1, TEMPE, AZ 85283-1247
(602) 264-4600
(602) 264-7325
Mailing address
600 E BASELINE RD, SUITE C-1, TEMPE, AZ 85283-1247
(602) 264-4600
(602) 264-7325
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1045
AZ
Other
Enumeration date
04/19/2006
Last updated
07/08/2007
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