Individual
NANCY DEANE GOOD MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LSPE
Contact information
Practice address
6144 CUMBERLAND GAP PARKWAY, SUITE 2, HARROGATE, TN 37752
(423) 626-6352
Mailing address
PO BOX 1604, NEW TAZEWELL, TN 37824-1604
(423) 626-6352
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
SPE 1475
TN
Other
Enumeration date
09/12/2006
Last updated
01/09/2009
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