Individual
TONY GOUDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
RT 4 & 20 SOUTH, 2ND FLOOR, ROCK CAVE, WV 26234
(304) 924-9081
Mailing address
PO BOX 129, BUCKHANNON, WV 26201-0129
(304) 473-8988
(304) 472-9849
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
671
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0164853000
—
WV
Enumeration date
05/15/2007
Last updated
07/08/2007
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