Individual
MR. KIRK JUDE DOUGLAS GODDARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., L.L.P.
Contact information
Practice address
28303 JOY RD, WESTLAND, MI 48185-5524
(734) 513-1122
Mailing address
424 W 5TH ST, ROYAL OAK, MI 48067-2573
(248) 318-7985
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301007324
MI
Other
Enumeration date
05/21/2008
Last updated
05/21/2008
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