Individual
MS. MICHELLE GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,CCC
Contact information
Practice address
2745 STILLWATER LAKE LN, MARIETTA, GA 30066-7904
(678) 612-5693
Mailing address
2745 STILLWATER LAKE LN, MARIETTA, GA 30066-7904
(678) 612-5693
(678) 612-5693
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP005627
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
939742314B
—
GA
Enumeration date
11/16/2006
Last updated
07/25/2011
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