Provider Demographics
NPI:1265442859
Name:GOEHRING, MARTY M (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARTY
Middle Name:M
Last Name:GOEHRING
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:8600 ACADEMY RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-1107
Mailing Address - Country:US
Mailing Address - Phone:505-821-3628
Mailing Address - Fax:505-856-7103
Practice Address - Street 1:8600 ACADEMY RD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-1107
Practice Address - Country:US
Practice Address - Phone:505-821-3628
Practice Address - Fax:505-856-7103
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM430103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical