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Individual

LINDA EILEEN GOODMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, LPC

Contact information

Practice address
510 W 29TH ST, CHEYENNE, WY 82001-2760
(307) 632-9362
Mailing address
510 W 29TH ST, CHEYENNE, WY 82001-2760
(307) 632-9362

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
268
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
310939
BS
WY
Enumeration date
07/12/2005
Last updated
04/25/2017
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