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Individual

JO ANNA GOODMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSS

Contact information

Practice address
1400 W MARINE DR APT 78, ASTORIA, OR 97103-5623
(503) 791-7086
Mailing address
1400 W MARINE DR APT 78, ASTORIA, OR 97103-5623
(503) 791-7086

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
112889
OR

Other

Enumeration date
03/19/2025
Last updated
03/19/2025
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