Individual
MS. BIANCA D GOODRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-INTERN
Contact information
Practice address
205 W OLMOS DR, SAN ANTONIO, TX 78212-1957
(210) 736-4847
(210) 832-8919
Mailing address
205 W OLMOS DR, SAN ANTONIO, TX 78212-1957
(210) 736-4847
(210) 832-8919
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
73119
TX
Other
Enumeration date
07/21/2016
Last updated
07/21/2016
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