Individual
DR. BRADLEY DENVER GOODELL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
500 HIGHWAY 96 W, SUITE 400, SHOREVIEW, MN 55126-1944
(651) 243-1513
Mailing address
500 HIGHWAY 96 W, SUITE 400, SHOREVIEW, MN 55126-1944
(651) 243-1513
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/09/2013
Last updated
01/09/2013
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