Individual
GRACE GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
250 S G ST, SAN BERNARDINO, CA 92410-3320
(909) 382-7100
(909) 382-7101
Mailing address
250 S G ST, SAN BERNARDINO, CA 92410-3320
(909) 382-7100
(909) 382-7101
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
28905
CA
Other
Enumeration date
09/20/2013
Last updated
02/03/2017
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