Individual
AVIVA RACHEL GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 NORTHERN BLVD STE 114, GREAT NECK, NY 11021-5312
(443) 255-6485
Mailing address
1000 NORTHERN BLVD STE 114, GREAT NECK, NY 11021-5312
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
012544
NY
101YM0800X
Mental Health Counselor
LC11018
MD
Other
Enumeration date
10/07/2022
Last updated
10/07/2022
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