Individual
CANANDRA GOODALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9165 OTIS AVE STE 229, INDIANAPOLIS, IN 46216-2321
(317) 455-6744
Mailing address
9165 OTIS AVE STE 229, INDIANAPOLIS, IN 46216-2321
(317) 455-6744
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
23016345-1
IN
3747A0650X
Attendant Care Provider
—
IN
Other
Enumeration date
05/08/2024
Last updated
07/31/2024
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