| Doctor Name: | DR. MICHAEL DEAN GOODMAN |
| NPI Number: | 1013344837 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D., MINISTER |
| License Number: | |
| Business Practice Address: | 6822 Bridlewood Ct Boca Raton, FL - 334333566 |
| Business Phone Number: | 5613503930 |
| Business Fax Number: | |
| Mailing Address: | 6822 Bridlewood Ct, BOCA RATON |
| State: | FL |
| Postal Code: | 334333566 |
| Phone Number: | 5613503930 |
| Fax Number: | |
| NPI Enumeration Date: | 10/11/2013 |
| NPI Last Update Date: | 09/27/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP1600X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Pastoral |
| Taxonomy Definition: | |