Provider Demographics
NPI:1528118379
Name:GOLDSBY, DONDRA
Entity type:Individual
Prefix:
First Name:DONDRA
Middle Name:
Last Name:GOLDSBY
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 1:2166 PELHAM PKWY
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-1131
Mailing Address - Country:US
Mailing Address - Phone:205-626-9676
Mailing Address - Fax:
Practice Address - Street 1:2166 PELHAM PKWY
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-1131
Practice Address - Country:US
Practice Address - Phone:205-626-9676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2024-03-19
Deactivation Date:2018-10-10
Deactivation Code:
Reactivation Date:2019-09-25
Provider Licenses
StateLicense IDTaxonomies
AL297106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist