Individual
DESTINY ROSE GOODSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSAC SUPERVISEE
Contact information
Practice address
1520 SLATE CREEK RD STE 201, GRUNDY, VA 24614-6975
(276) 242-2001
Mailing address
1520 SLATE CREEK RD STE 201, GRUNDY, VA 24614-6975
(276) 242-2001
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0709025109
VA
Other
Enumeration date
03/23/2023
Last updated
03/22/2024
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