Provider Demographics
NPI:1619150281
Name:GOLDENSOHN, ANDREA MOSS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:MOSS
Last Name:GOLDENSOHN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3204 TOWER OAKS BLVD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:ROCKVILLE
Mailing Address - State:MP
Mailing Address - Zip Code:20852-4250
Mailing Address - Country:US
Mailing Address - Phone:301-468-7711
Mailing Address - Fax:301-468-7717
Practice Address - Street 1:3204 TOWER OAKS BLVD
Practice Address - Street 2:SUITE 310
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4250
Practice Address - Country:US
Practice Address - Phone:301-468-7711
Practice Address - Fax:301-468-7717
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02254103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical