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Individual

MS. DIANE MARIE GODDARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
8122 DATAPOINT DR STE 1003, SAN ANTONIO, TX 78229-3273
(210) 261-1500
(210) 261-1837
Mailing address
6800 PARK TEN BLVD STE 200S, SAN ANTONIO, TX 78213-4293
(210) 287-4472
(210) 261-1821

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
256951
TX

Other

Enumeration date
10/06/2009
Last updated
12/17/2019
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