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1215644141
CLARENCE WILFRED GODDARD
ESPANOLA, NM
NPI
1215644141
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NM CAD0210951)
Enumeration Date
2022-10-31
Last Update Date
2022-10-31
Business Address
Mr. CLARENCE WILFRED GODDARD MA LADAC
807 CALLE CHAMISAL
ESPANOLA, NM 87532-2976
Phone number: 505-372-4511
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Mailing Address
Mr. CLARENCE WILFRED GODDARD MA LADAC
PO BOX 1775
ESPANOLA, NM 87532-1775
Phone number: 505-423-4617
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