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1194156216
KRISTY DIANE GOODSON
AMMON, ID
NPI
1194156216
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker Clinical
(Licence: ID LCSW-38393)
Enumeration Date
2013-11-30
Last Update Date
2023-08-02
Business Address
KRISTY DIANE GOODSON
1675 CURLEW DR
AMMON, ID 83406-4718
Phone number: 208-523-5319
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Mailing Address
KRISTY DIANE GOODSON
PO BOX 2106
IDAHO FALLS, ID 83403-2106
Phone number: 208-523-5319
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