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Individual

DR. CARY K GOODMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
2335 BLACK ROCK TPKE, FAIRFIELD, CT 06825
(203) 334-7411
(203) 372-7596
Mailing address
63 SHERLEY PLACE, FAIRFIELD, CT 06825
(203) 576-1371

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2056
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004250370
CT
01
060002056CT01
ANTEHM BC BS
CT
01
353667
MHN
CT
Enumeration date
10/04/2006
Last updated
07/08/2007
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