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Individual

LESLIE DAWN GOODMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
14430 NS 3500, KONAWA, OK 74849-4901
(580) 925-2650
Mailing address
14430 NS 3500, KONAWA, OK 74849-4901
(580) 925-2650

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01
VALLIANT HOUSE
Enumeration date
01/02/2021
Last updated
01/02/2021
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Product
  • Claims
  • Eligibility checks
  • EDI platform