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General NPI Number Information
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NPI Number | 1700189537
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Entity Type | Individual
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Provider Name | CINDY SHARON GOETZ CDP
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Gender | Female
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Dates
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Enumeration Date | 12/16/2010
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Last Update Date | 12/16/2010
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Provider Practice Location Address
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Address Line | 1055 9TH AVE STE D
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City | LONGVIEW
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State | WA
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Zip | 98632-2661
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Country | US
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Telephone | 360-575-3315
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Fax |
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Provider Business Mailing Address
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Address Line | 1028 19TH AVE
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City | LONGVIEW
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State | WA
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Zip | 98632-2213
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Country | US
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Telephone | 360-749-0258
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CP00002160
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License Number State | WA
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