Individual
JEFFREY GOODELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
67 SHAKER RD, GRAY, ME 04039-9640
(207) 657-7700
Mailing address
67 SHAKER RD, GRAY, ME 04039-9640
(207) 657-7700
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
MC15203
ME
Other
Enumeration date
01/29/2015
Last updated
01/29/2015
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