Most Relevant Information
Provider Data
| NPI Number: | 1003342478 |
| Provider Name: | BOBBY JOE GOODMAN M.A. |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/04/2017 |
| Last Updated: | 05/19/2023 |
Provider Practice Location
5501 DELMAR BLVD STE B300
SAINT LOUIS
MO
631123078
Practice Location Phone/Fax
| Phone: | 3144694908 |
| Fax: |
Provider Mailing Location
5501 DELMAR BLVD STE B300
SAINT LOUIS
MO
631123078
Provider Mailing Phone/Fax
| Phone: | 3144694908 |
| Fax: |