| NPI | 1659794469 |
|---|---|
| Former Name | LESLIE KAREN GODDARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 19631) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TN 6871) |
| 1041C0700X Social Worker, Clinical (Licence: VA 0904010656) | |
| Enumeration Date | 2014-01-30 |
| Last Update Date | 2024-08-14 |