Individual
MICHAEL S GODDARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1741 ASHLAND AVE, BALTIMORE, MD 21205-1531
(443) 923-7943
Mailing address
1223 N CALVERT ST APT 2, BALTIMORE, MD 21202-1387
(516) 456-4142
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
06675
MD
Other
Enumeration date
08/14/2021
Last updated
11/03/2021
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