Doctor Name: | BRENDA R. GOODINE |
NPI Number: | 1093973398 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MHRT-C |
License Number: | |
Business Practice Address: | 43 Vickers Dr Caribou, ME - 047363884 |
Business Phone Number: | 2074980922 |
Business Fax Number: | 2074923181 |
Mailing Address: | 43 Vickers Dr, CARIBOU |
State: | ME |
Postal Code: | 047363884 |
Phone Number: | 2074980922 |
Fax Number: | 2074923181 |
NPI Enumeration Date: | 05/23/2008 |
NPI Last Update Date: | 05/23/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |