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Individual

KRISTY DIANE GOODSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1675 CURLEW DR, AMMON, ID 83406-4718
(208) 523-5319
Mailing address
PO BOX 2106, IDAHO FALLS, ID 83403-2106
(208) 523-5319

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-38393
ID

Other

Enumeration date
11/30/2013
Last updated
08/02/2023
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