Individual
MRS. ANIKKA L GOODMAN-CUSTODIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
2255 CHALLENGER WAY STE 107, SANTA ROSA, CA 95407-5423
(707) 565-6174
Mailing address
PO BOX 358, VALLEY FORD, CA 94972-0358
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
131001
CA
Other
Enumeration date
04/25/2017
Last updated
02/16/2025
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