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Individual

WILLIAM ALFRED GOODMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
160 BENMONT AVE, SUITE 25, BENNINGTON, VT 05201-1873
(802) 447-7577
(802) 447-2676
Mailing address
160 BENMONT AVE, SUITE 25, BENNINGTON, VT 05201-1873
(802) 447-7577
(802) 447-2676

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
042-0000722
VT
103T00000X
Psychologist
4767
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0522325
MA
05
0VN1788
VT
Enumeration date
09/02/2005
Last updated
03/27/2009
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