Individual
MICHAEL LEE GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CAC
Contact information
Practice address
777 BANNOCK ST UNIT 9, DENVER, CO 80204-4507
(303) 436-5686
Mailing address
777 BANNOCK ST UNIT 9, DENVER, CO 80204-4507
(303) 436-5686
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6461
CO
Other
Enumeration date
04/13/2012
Last updated
04/13/2012
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