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Individual

HOLLY RAE GOODALE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CSA, LSA, CSFA

Contact information

Practice address
5801 BREMO RD, RICHMOND, VA 23226-1907
(804) 285-2011
Mailing address
2801 E MAIN ST APT 716, RICHMOND, VA 23223-7917
(301) 956-5489

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
0136000808
VA

Other

Enumeration date
06/15/2023
Last updated
05/12/2025
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