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Individual

JESSICA L GOODALE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
464 CENTRAL AVE S, BEACH, ND 58621
(406) 855-3615
Mailing address
PO BOX 164, BEACH, ND 58621-0164
(406) 855-3615

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
1481080
ND

Other

Enumeration date
12/08/2020
Last updated
12/08/2020
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