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Individual

DANIELLE S GOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2114 E FAIRVIEW AVE, JOHNSON CITY, TN 37601-2858
(423) 928-6464
(423) 232-7970
Mailing address
PO BOX 191, JOHNSON CITY, TN 37605-0191
(423) 928-6464
(423) 232-7970

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6126
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
115467662
DRIVER'S LICENSE
TN
Enumeration date
01/14/2019
Last updated
01/14/2019
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