Individual
MS. ETHEL ANN GOODNOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
2418 MILES RD SE, ALBUQUERQUE, NM 87106
(505) 243-2923
(505) 842-1503
Mailing address
2418 MILES RD SE, ALBUQUERQUE, NM 87106
(505) 243-2923
(505) 842-5103
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I1921
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
I1921
STATE LICENSE NUMBER
NM
Enumeration date
11/13/2006
Last updated
07/08/2007
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