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General NPI Number Information
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NPI Number | 1669606976
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Entity Type | Individual
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Provider Name | ANDREA TERESE GODDARD LMHC, NCC
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Gender | Female
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Dates
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Enumeration Date | 05/14/2009
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Last Update Date | 02/23/2011
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Provider Practice Location Address
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Address Line | 707 W 7TH AVE STE 260 ATTN: ANDREA
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City | SPOKANE
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State | WA
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Zip | 99204-2821
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Country | US
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Telephone | 509-220-9841
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Fax |
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Provider Business Mailing Address
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Address Line | 707 W 7TH AVE STE 260 ATTN: ANDREA
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City | SPOKANE
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State | WA
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Zip | 99204-2821
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Country | US
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Telephone | 509-220-9841
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Fax | 509-624-1615
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH 60040714
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License Number State | WA
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