Individual
MRS. LISA GODMAN OULD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
906 N PARHAM RD, RICHMOND, VA 23229-6456
(804) 716-2796
Mailing address
4507 FITZHUGH AVE, RICHMOND, VA 23230-3730
(804) 716-2796
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
3764
NC
Other
Enumeration date
06/22/2009
Last updated
06/22/2009
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