Individual
MS. MINA ARIELLA GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
20440 N 27TH AVE, PHOENIX, AZ 85027-3240
(480) 882-4545
Mailing address
1111 E UNIVERSITY DR UNIT 205, TEMPE, AZ 85281-4265
(646) 256-5977
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86093671
AZ
Other
Enumeration date
08/20/2019
Last updated
06/05/2020
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