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Individual

JANINA GOODMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
11675 E THUNDERBIRD TRL, TUCSON, AZ 85749-9502
(708) 259-3017
Mailing address
21630 N 19TH AVE STE B3, PHOENIX, AZ 85027-2717
(602) 726-2300

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056008996
IL
225X00000X
Occupational Therapist
Primary
4775
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
615070
AZ
Enumeration date
04/05/2010
Last updated
12/09/2019
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