| NPI | 1669931374 |
|---|---|
| Former Name | LORI KAY GOODRICH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA 127041) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2019-03-13 |