Individual
MRS. COLLEEN KAE GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS/LSW
Contact information
Practice address
3095 KETTERING BLVD, MORAINE, OH 45439-1983
(937) 293-8300
(937) 534-1350
Mailing address
3095 KETTERING BLVD, MORAINE, OH 45439-1983
(937) 293-8300
(937) 534-1350
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S.0600209
OH
Other
Enumeration date
11/24/2021
Last updated
12/10/2021
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