Individual provider · Type 1 NPI

Wallace Goodman

Addiction (Substance Use Disorder) Counselor · Hayti, MO

NPI number 1427488055 Active

Practice location

501 Highway J N
Hayti, MO 63851

Call (573) 359-2600 Map

Mailing address

2009 Southwind Cv
Dyersburg, TN 38024-8875

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X2011024580 (MO)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1427488055

Wallace Goodman's National Provider Identifier is 1427488055, issued on Nov 18, 2013. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Hayti, MO. The record was last updated on Nov 18, 2013.