Provider Demographics
NPI:1770740136
Name:GOYAL, SANEHA REENA (PSYD)
Entity type:Individual
Prefix:DR
First Name:SANEHA
Middle Name:REENA
Last Name:GOYAL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 748519
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-8519
Mailing Address - Country:US
Mailing Address - Phone:904-376-3800
Mailing Address - Fax:904-376-3998
Practice Address - Street 1:14540 OLD SAINT AUGUSTINE RD STE 2591
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-7420
Practice Address - Country:US
Practice Address - Phone:904-376-3800
Practice Address - Fax:904-376-3998
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL PY 6627103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical