Individual
AUDRA MAE GOODLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 SCHOOL ST, WILLIAMSTON, MI 48895-1327
(734) 718-6994
Mailing address
4100 FREIERMUTH RD, STOCKBRIDGE, MI 49285-9520
(517) 851-2242
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6451022279
MI
Other
Enumeration date
08/16/2022
Last updated
08/16/2022
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