Individual
MARY GOODYEAR I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1120 N HIGHLAND AVE NE, ATLANTA, GA 30306-3492
(706) 829-6864
Mailing address
1120 N HIGHLAND AVE NE, ATLANTA, GA 30306-3492
(706) 829-6864
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/28/2016
Last updated
12/28/2016
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