Individual
SAMUEL DENTON GOODE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 W DANIELS ST, OZARK, MO 65721-7322
(417) 719-2057
Mailing address
1100 E PORTLAND ST, SPRINGFIELD, MO 65807-1870
(417) 920-7199
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-359246
MO
Other
Enumeration date
07/03/2024
Last updated
07/03/2024
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