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General NPI Number Information
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NPI Number | 1477784296
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Entity Type | Individual
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Provider Name | MR. YOHANCE S GOODRICH
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Gender | Male
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Dates
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Enumeration Date | 07/28/2009
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Last Update Date | 07/28/2009
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Provider Practice Location Address
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Address Line | 719 N 25TH ST
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City | RICHMOND
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State | VA
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Zip | 23223-6539
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Country | US
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Telephone | 804-643-0002
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Fax | 804-643-3106
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Provider Business Mailing Address
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Address Line | 8245 GRAVES RD
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City | PETERSBURG
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State | VA
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Zip | 23803-1209
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Country | US
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Telephone | 804-712-2974
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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