Individual
DAKOTA R GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SAC-IT
Contact information
Practice address
2213 E MAIN ST, REEDSBURG, WI 53959-9439
(608) 768-4545
Mailing address
2213 E MAIN ST, REEDSBURG, WI 53959-9439
(608) 768-4545
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18868-130
WI
Other
Enumeration date
06/18/2019
Last updated
06/18/2019
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