Individual
MS. ROBERTA R GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPAT
Contact information
Practice address
187 TESUQUE VILLAGE RD, TESUQUE, NM 87506
(505) 988-3686
(505) 310-1576
Mailing address
PO BOX 1111, SANTA FE, NM 87504-1111
(505) 988-3686
(505) 310-1576
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0438
NM
Other
Enumeration date
11/09/2006
Last updated
05/21/2009
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