Individual
MRS. TASHA M GOODEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6115 HICKORY GROVE RD, CHARLOTTE, NC 28215-4207
(704) 532-4262
(704) 532-7617
Mailing address
650 S PEORIA AVE, TULSA, OK 74120-4429
(918) 587-9471
(918) 560-1399
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
25979
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100746170G
—
OK
Enumeration date
09/11/2009
Last updated
02/11/2022
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