Individual
BETHANI J GOODRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2344 HELEN ST N, NORTH SAINT PAUL, MN 55109-2942
(952) 746-5350
Mailing address
14301 EWING AVE S, BURNSVILLE, MN 55306-4885
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
07/02/2018
Last updated
05/15/2023
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