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Individual

GREGORY B GOODRICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
5924 US HIGHWAY 285, MORRISON, CO 80465-9101
(303) 697-0235
Mailing address
9225 SANDY LN, CONIFER, CO 80433-9501

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
120704
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
120704
TRIBAL LICENSE
MN
Enumeration date
01/26/2007
Last updated
02/01/2021
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