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General NPI Number Information
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NPI Number | 1700535515
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Entity Type | Individual
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Provider Name | SYLVIA LU GOODMAN MFT
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Gender | Female
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Dates
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Enumeration Date | 03/20/2022
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Last Update Date | 03/20/2022
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Provider Practice Location Address
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Address Line | 239 MILLER AVE STE 3
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City | MILL VALLEY
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State | CA
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Zip | 94941-2866
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Country | US
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Telephone | 415-455-4774
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 613
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City | WOODACRE
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State | CA
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Zip | 94973-0613
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Country | US
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Telephone | 415-786-5392
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC37612
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License Number State | CA
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