Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1013344837 |
---|---|
Provider Name | Dr. Michael Dean Goodman |
First Address | Boca Raton, FL 33433-3566 |
Second Address | Boca Raton, FL 33433-3566 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2013 |
Last Update Date | 27/09/2014 |