Individual
TRACI GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1521 WRIGHT ST, HENDERSON, KY 42420-4553
(270) 577-7912
Mailing address
1521 WRIGHT ST, HENDERSON, KY 42420-4553
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001623A
IN
Other
Enumeration date
04/16/2014
Last updated
04/16/2014
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