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Individual

DR. MARK DAVID GOODMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD FPPR

Contact information

Practice address
125 W. 2ND AVENUE, SUITE E, HUTCHINSON, KS 67501-5300
(620) 663-4802
(620) 663-9867
Mailing address
PO BOX 1221, HUTCHINSON, KS 67504-1221
(620) 663-4802
(620) 663-9867

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
374
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100237680A
KS
Enumeration date
03/29/2006
Last updated
01/31/2017
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