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General NPI Number Information
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NPI Number | 1881968824
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Entity Type | Individual
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Provider Name | BRIDGETTE GODDARD LMFTA,LCDC
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Gender | Female
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Dates
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Enumeration Date | 03/07/2012
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Last Update Date | 03/07/2012
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Provider Practice Location Address
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Address Line | 11500 N W FWY STE 200K
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City | HOUSTON
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State | TX
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Zip | 77092-6541
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Country | US
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Telephone | 713-907-6667
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Fax |
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Provider Business Mailing Address
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Address Line | 101 HOLLOW TREE LN APT 13201
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City | HOUSTON
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State | TX
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Zip | 77090-1745
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Country | US
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Telephone | 713-907-6667
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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 | 10588
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 201667
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License Number State | TX
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