Provider Information for 1962557918
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HOLLY ELIZABETH GOODMAN LCSW
Sex: Female
NPI: 1962557918
Last Updated: 2019-02-25
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1962557918 | ||||||||||||
| Enumeration Date | 2007-01-23 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 101 CABARRUS AVE E STE 200 CONCORD, NC 28025-3781 United States Phone: 888-849-7379 | Fax:855-857-7333 | ||||||||||||
| Primary Practice Address | 101 CABARRUS AVE E STE 200 CONCORD, NC 28025 United States Phone: 888-849-7379 | Fax:855-857-7333 | ||||||||||||
| Secondary Practice Address(es) | 952 COPPERFIELD BLVD NE 952 COPPERFIELD BLVD NE | ||||||||||||
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