Individual
MR. MICHAEL RAY GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
10820 SUNSET OFFICE DR, SAINT LOUIS, MO 63127-1016
(314) 809-7434
Mailing address
13451 LAND O WOODS DR, SAINT LOUIS, MO 63141-6027
(314) 809-7434
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
002144
MO
Other
Enumeration date
11/27/2019
Last updated
11/27/2019
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