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NPI Code Detail

MEDICARE: MORGAN MARIE GOODSON B.S.W.

MEDICARE: MORGAN MARIE GOODSON B.S.W.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1134899586
Entity Type Code : Individual
Provider Name (Legal Business Name) : MORGAN MARIE GOODSON B.S.W.
Provider Business Mailing Address
First Line : 1500 S DOUGLAS RD STE 230
Second Line :
City : CORAL GABLES
State : FL
Zip : 33134-4108
Country : US
Telephone Number : 844-854-1116
Fax Number : 305-846-9711
Provider Business Practice Location Address
First Line : 538 BRANDIES CIR STE 102
Second Line :
City : MURFREESBORO
State : TN
Zip : 37128-8423
Country : US
Telephone Number : 844-854-1116
Fax Number : 305-846-9711
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2021
Last Update Date : 09/17/2021

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