Provider Demographics
NPI:1316165780
Name:GOULDING, SUNDIE
Entity type:Individual
Prefix:
First Name:SUNDIE
Middle Name:
Last Name:GOULDING
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 1:1830 ANTIETAM ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-1124
Mailing Address - Country:US
Mailing Address - Phone:412-983-7795
Mailing Address - Fax:
Practice Address - Street 1:37634 ENTERPRISE CT
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-3440
Practice Address - Country:US
Practice Address - Phone:248-553-0902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor