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Individual
TYRA LEI GOODMAN
Active
Individual
TYRA LEI GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W., M.S.W.
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
004414
FL
1041C0700X
Clinical Social Worker
Primary
COO 6410
NC
Other
Enumeration date
06/22/2009
Last updated
02/17/2021
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