Individual
ALISA GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2323 W FRONT ST, TYLER, TX 75702-7704
(903) 597-1351
(903) 535-7386
Mailing address
2323 W FRONT ST, TYLER, TX 75702-7704
(903) 597-1351
(903) 535-7386
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
14870
TX
Other
Enumeration date
10/10/2012
Last updated
10/10/2012
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