Individual
DAVID WAYNE GOODMAN
Active
Individual
DAVID WAYNE GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
072002957
IL
103TC1900X
Counseling Psychologist
Primary
0852
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03624
BCBSNC
NC
05
—
6000021
—
NC
Enumeration date
07/11/2006
Last updated
08/27/2012
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