Individual
GLENN GOODRICH III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
77 E COLUMBUS AVE STE 210, PHOENIX, AZ 85012-2351
(602) 230-7373
Mailing address
3620 N 3RD ST, PHOENIX, AZ 85012-2020
(602) 230-7373
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-17981
AZ
Other
Enumeration date
04/10/2019
Last updated
04/10/2019
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