Individual
DR. MICHAEL STUART GOLDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
547 S VENANGO DR, PUEBLO WEST, CO 81007-7055
(719) 248-9343
Mailing address
547 S VENANGO DR, PUEBLO WEST, CO 81007-7055
(719) 281-5056
(719) 960-2475
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2169
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07021694
—
CO
Enumeration date
07/11/2006
Last updated
10/26/2019
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