Individual
AMY ELIZABETH GOODGAME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2323 W CHESTNUT ST STE 6, ROGERS, AR 72756-3520
(479) 346-5459
Mailing address
2323 W CHESTNUT ST STE 6, ROGERS, AR 72756-3520
(479) 346-5459
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
AR
224Z00000X
Occupational Therapy Assistant
Primary
OT-A1962
AR
Other
Enumeration date
10/02/2023
Last updated
11/09/2023
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