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Individual
KATE GOODSPEED
Active
Individual
KATE GOODSPEED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.S., M.A., PHARM.D.
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
55500
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
183500000X
TAXONOMY
TX
01
—
55500
TSBP LICENSE
TX
Enumeration date
10/13/2014
Last updated
10/13/2014
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