NPI | 1700918901 |
---|---|
Former Name | BARBRA RACHELLE GOODNOUGH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0003874) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACC.0006558) |
101YP2500X Counselor, Professional (Licence: CO LPC.0003874) | |
Enumeration Date | 2007-03-12 |
Last Update Date | 2024-09-11 |