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1285346635
SHANNON KIVA GOODMAN
GARDEN GROVE, CA
NPI
1285346635
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Former Name
SHANNON KIVA GOODMAN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
Enumeration Date
2022-12-16
Last Update Date
2022-12-16
Business Address
SHANNON KIVA GOODMAN
6615 ANTHONY AVE
GARDEN GROVE, CA 92845-2207
Phone number: 502-649-2110
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Mailing Address
SHANNON KIVA GOODMAN
6615 ANTHONY AVE
GARDEN GROVE, CA 92845-2207
Phone number: 502-649-2110
Copy
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