Individual
MIRANDA GOODSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3700 KENNEDY ST, HYATTSVILLE, MD 20782-3838
(917) 742-3125
Mailing address
3700 KENNEDY ST, HYATTSVILLE, MD 20782-3838
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
07912
MD
Other
Enumeration date
04/21/2016
Last updated
04/21/2016
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