Most Relevant Information
Provider Data
| NPI Number: | 1003036302 |
| Provider Name: | COURTNEY ELAINE GOODRUM LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 1611-C |
Most Important Dates
| Enumeration Date: | 04/27/2007 |
| Last Updated: | 07/30/2024 |
Provider Practice Location
1 W SUNBRIDGE DR
FAYETTEVILLE
AR
727031825
Practice Location Phone/Fax
| Phone: | 4794435575 |
| Fax: |
Provider Mailing Location
1 W SUNBRIDGE DR
FAYETTEVILLE
AR
727031825
Provider Mailing Phone/Fax
| Phone: | 4794435575 |
| Fax: | 4797508967 |