Individual
AMANDA FRIEDLEY GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1904 RICHLAND AVE, CERES, CA 95307-4562
(209) 525-7411
Mailing address
201 E COOLIDGE AVE APT C7, MODESTO, CA 95350-4581
(209) 409-9984
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1456890122
CA
Other
Enumeration date
02/01/2022
Last updated
09/20/2023
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