Provider Demographics
NPI:1467776369
Name:GOETZINGER, AMY M (PHD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:M
Last Name:GOETZINGER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 ANNABELLE BRANCH LN
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27523-5825
Mailing Address - Country:US
Mailing Address - Phone:919-536-9844
Mailing Address - Fax:
Practice Address - Street 1:410 MARKET ST STE 362
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-4061
Practice Address - Country:US
Practice Address - Phone:984-974-6688
Practice Address - Fax:984-974-6793
Is Sole Proprietor?:No
Enumeration Date:2010-03-22
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3820103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist