Individual
ELI JUSTIN GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1440 DUCKWOOD DR STE 500, EAGAN, MN 55122-1399
(612) 440-7250
Mailing address
2044 OAKDALE AVE APT 105, WEST ST PAUL, MN 55118-4671
(763) 354-9591
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11305
MN
Other
Enumeration date
05/04/2026
Last updated
05/04/2026
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