| NPI | 1902025216 |
|---|---|
| Former Name | VICKTORIA G GOODMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 2994) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 1925) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2013-01-08 |