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Individual

LORI NICOLE GOODMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BCABA

Contact information

Practice address
2041 MILLER AVE, CHESAPEAKE, VA 23320-2435
(757) 617-5815
Mailing address
2041 MILLER AVE, CHESAPEAKE, VA 23320-2435
(757) 617-5815

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Enumeration date
11/01/2012
Last updated
11/01/2012
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