Individual
JESSICA GOODISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
556 CLINTON AVE S, ROCHESTER, NY 14620-1105
(585) 442-8422
(585) 442-8494
Mailing address
79 GLENRIDGE RD, GLENVILLE, NY 12302-4528
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
38677-T
NY
Other
Enumeration date
04/14/2023
Last updated
05/19/2023
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