Doctor Name: | BRIDGID MARIE GOODE |
NPI Number: | 1538402649 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT |
License Number: | 7430 |
Business Practice Address: | 2032 Rose Ln Las Cruces, NM - 880051456 |
Business Phone Number: | 5755256655 |
Business Fax Number: | |
Mailing Address: | 5140 Del Rey Blvd, LAS CRUCES |
State: | NM |
Postal Code: | 880127331 |
Phone Number: | 5165325611 |
Fax Number: | |
NPI Enumeration Date: | 03/27/2013 |
NPI Last Update Date: | 03/27/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 7430 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |