Individual provider · Type 1 NPI

Brandon Lee Goodly

Peer Specialist · Lake Charles, LA

NPI number 1104448612 Active

Practice location

751 Bayou Pines East Dr Ste C
Lake Charles, LA 70601-7196

Call (337) 433-3292 Map

Mailing address

8326 Kelwood Ave
Baton Rouge, LA 70806-4803

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist Primary 175T00000XNone listed

Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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About NPI 1104448612

Brandon Lee Goodly's National Provider Identifier is 1104448612, issued on May 7, 2020. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Lake Charles, LA. The record was last updated on May 7, 2020.