Most Relevant Information
Provider Data
| NPI Number: | 1003669250 |
| Provider Name: | AMY MELISSA GOODSON |
| Entity Type: | Individual |
| Taxonomy Code: | 106H00000X |
| Specialty: | Marriage & Family Therapist |
| License Number: | 144059 |
Most Important Dates
| Enumeration Date: | 04/08/2024 |
| Last Updated: | 11/07/2024 |
Provider Practice Location
1336 BRIDGEGATE DR
DIAMOND BAR
CA
917653955
Practice Location Phone/Fax
| Phone: | 6268511011 |
| Fax: |
Provider Mailing Location
4026 N NORA AVE
COVINA
CA
917223820
Provider Mailing Phone/Fax
| Phone: | 6266783130 |
| Fax: |