Provider Demographics
NPI:1538694559
Name:GOLDEN, JEANNIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JEANNIE
Middle Name:
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:104 RAWL BUILDING
Mailing Address - Street 2:DEPARTMENT OF PSYCHOLOGY EAST CAROLINA UNIVERSITY
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858
Mailing Address - Country:US
Mailing Address - Phone:252-328-6206
Mailing Address - Fax:252-328-6283
Practice Address - Street 1:104 RAWL BUILDING
Practice Address - Street 2:DEPARTMENT OF PSYCHOLOGY EAST CAROLINA UNIVERSITY
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858
Practice Address - Country:US
Practice Address - Phone:252-328-6206
Practice Address - Fax:252-328-6283
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-27
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC1262103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist