Individual
CORETTA GODBOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 N GREENLEAF ST STE B, GURNEE, IL 60031-3326
(847) 390-2271
Mailing address
710 GLEN ROCK AVE APT 2, WAUKEGAN, IL 60085-5460
(847) 390-2271
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
G314-1007-2713
IL
Other
Enumeration date
05/18/2026
Last updated
05/18/2026
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