Individual
HOLLYE GOODSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
950 N 4TH ST, LONGVIEW, TX 75601-5436
(903) 758-2471
Mailing address
950 N 4TH ST, LONGVIEW, TX 75601-5436
(903) 758-2471
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13519
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13519
LCDC
TX
Enumeration date
06/22/2016
Last updated
06/22/2016
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