Provider Demographics
NPI:1467717835
Name:GOLDSBY, DAVID
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:GOLDSBY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E 32ND ST
Mailing Address - Street 2:APT. 1905
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-4052
Mailing Address - Country:US
Mailing Address - Phone:478-737-6842
Mailing Address - Fax:
Practice Address - Street 1:401 E 32ND ST
Practice Address - Street 2:APT. 1905
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-4052
Practice Address - Country:US
Practice Address - Phone:478-737-6842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst