Individual
ADA GOODWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
291 N 200 W, TOOELE, UT 84074-1507
(435) 830-6225
Mailing address
291 N 200 W, TOOELE, UT 84074-1507
(435) 830-6225
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/15/2016
Last updated
01/13/2017
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