Individual
CARLA LESLIE-GOODEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
170 BASTILLE WAY STE A, FAYETTEVILLE, GA 30214-7652
(678) 870-4467
(770) 626-3421
Mailing address
PO BOX 292, UNION CITY, GA 30291-0292
(678) 870-4467
(770) 626-3421
Taxonomy
Speciality
Code
Description
License number
State
225XR0403X
Driving and Community Mobility Occupational Therapist
Primary
—
—
Other
Enumeration date
03/18/2016
Last updated
09/09/2020
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