Most Relevant Information
Provider Data
| NPI Number: | 1003354663 |
| Provider Name: | SUSAN GODDARD |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/03/2017 |
| Last Updated: | 02/03/2017 |
Provider Practice Location
415 US HIGHWAY 95A S
SUITE 702G
FERNLEY
NV
894089261
Practice Location Phone/Fax
| Phone: | 7755752284 |
| Fax: |
Provider Mailing Location
308 EDGEBROOK DR
SPRING CREEK
NV
898155709
Provider Mailing Phone/Fax
| Phone: | 7754011439 |
| Fax: |