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Individual

DR. LAWRENCE A GOODING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.S. & PH.D.

Contact information

Practice address
600 UNIVERSITY AVE, SUITE #4, FAIRBANKS, AK 99709-3643
(907) 479-8545
(907) 474-8165
Mailing address
600 UNIVERSITY AVE, SUITE #4, FAIRBANKS, AK 99709-3643
(907) 479-8545
(907) 474-8165

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
133
AK
385H00000X
Respite Care
133
AK
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
133
AK

Other

Enumeration date
11/21/2006
Last updated
06/10/2010
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