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1588107569
EVAN GOODMAN
FORT WAYNE, IN
NPI
1588107569
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: IN 20043165A)
Enumeration Date
2016-11-23
Last Update Date
2018-11-26
Business Address
EVAN GOODMAN
909 E STATE BLVD
FORT WAYNE, IN 46805-3404
Phone number: 260-482-9125
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Mailing Address
EVAN GOODMAN
909 E STATE BLVD
FORT WAYNE, IN 46805-3404
Phone number: 260-482-9125
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