Provider Demographics
NPI:1568073112
Name:GOIDA, KATHERINE
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:GOIDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 BAINBRIDGE ST APT 183
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23224-2385
Mailing Address - Country:US
Mailing Address - Phone:484-885-3404
Mailing Address - Fax:
Practice Address - Street 1:7143 STONEWALL PARKWAY
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111
Practice Address - Country:US
Practice Address - Phone:804-557-0881
Practice Address - Fax:804-601-3479
Is Sole Proprietor?:No
Enumeration Date:2020-08-16
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician