Individual
JOAN GOODALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8614 E STONEWOOD ST, EVANSVILLE, WY 82636-9635
(307) 265-2026
Mailing address
8614 E STONEWOOD ST, EVANSVILLE, WY 82636-9635
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
01/23/2007
Last updated
07/09/2007
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