Most Relevant Information
Provider Data
| NPI Number: | 1003237991 |
| Provider Name: | VICKI GOODMAN |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/19/2013 |
| Last Updated: | 12/19/2013 |
Provider Practice Location
619 N 500 W
PROVO
UT
846011547
Practice Location Phone/Fax
| Phone: | 8014200465 |
| Fax: | 8013754241 |
Provider Mailing Location
619 N 500 W
PROVO
UT
846011547
Provider Mailing Phone/Fax
| Phone: | 8014200465 |
| Fax: | 8013754241 |