Individual
JOSEPHINE LYNN GOOSHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
110 2ND AVE, FAIRBANKS, AK 99701-4809
(907) 452-7946
(907) 452-7942
Mailing address
1428 GILLAM WAY # 1, FAIRBANKS, AK 99701-6073
(907) 687-2781
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M0157
—
AK
Enumeration date
02/20/2012
Last updated
02/20/2012
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