Individual
MRS. CONSTANCE F GOODRUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
700 CHESTNUT ST, XENIA, OH 45385-5110
(937) 554-3298
Mailing address
700 CHESTNUT ST, XENIA, OH 45385-5110
(937) 554-3298
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
M.2300285
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001096
—
OH
Enumeration date
09/23/2022
Last updated
10/16/2023
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