NPI Code Details Logo

NPI 1366651879

NPI 1366651879 : GERI A GODDARD M.A., M.F.T. : RENO, NV

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1366651879
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    GERI A GODDARD M.A., M.F.T.
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    05/21/2007
-----------------------------------------------------
    Last Update Date     |    01/25/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    615 SIERRA ROSE DR STE 4 
-----------------------------------------------------
    City                 |    RENO
-----------------------------------------------------
    State                |    NV
-----------------------------------------------------
    Zip                  |    89511-4009
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    775-826-1002
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    4790 CAUGHLIN PKWY # 383 
-----------------------------------------------------
    City                 |    RENO
-----------------------------------------------------
    State                |    NV
-----------------------------------------------------
    Zip                  |    89509-0907
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    775-826-1002
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    106H00000X
-----------------------------------------------------
    Taxonomy Name        |    Marriage & Family Therapist
-----------------------------------------------------
    License Number       |    0587
-----------------------------------------------------
    License Number State |    NV
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.