EVAN GOODMAN

FORT WAYNE, IN
NPI1588107569
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy103TC0700X Psychologist, Clinical
(Licence: IN  20043165A)
Enumeration Date2016-11-23
Last Update Date2018-11-26
Business Address
EVAN GOODMAN
909 E STATE BLVD
FORT WAYNE, IN 46805-3404
Phone number: 260-482-9125
Mailing Address
EVAN GOODMAN
909 E STATE BLVD
FORT WAYNE, IN 46805-3404
Phone number: 260-482-9125
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