Provider Demographics
NPI:1962564989
Name:GOLD, SONDRA HELENE (PHD)
Entity type:Individual
Prefix:
First Name:SONDRA
Middle Name:HELENE
Last Name:GOLD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 EQUALITY PARK W
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-2603
Mailing Address - Country:US
Mailing Address - Phone:401-846-2049
Mailing Address - Fax:401-846-7243
Practice Address - Street 1:8 EQUALITY PARK W
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02840-2603
Practice Address - Country:US
Practice Address - Phone:401-846-2049
Practice Address - Fax:401-846-7243
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS00237103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical