Individual
DAVID WAYNE GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2639 SUNSET AVENUE, SUITE B, ROCKY MOUNT, NC 27804-3700
(252) 937-4455
(252) 937-3060
Mailing address
2639 SUNSET AVENUE, SUITE B, ROCKY MOUNT, NC 27804-3700
(252) 937-4455
(252) 937-3060
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
072002957
IL
103TC1900X
Counseling Psychologist
Primary
0852
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03624
BCBSNC
NC
05
—
6000021
—
NC
Enumeration date
07/11/2006
Last updated
08/27/2012
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