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NPI Code Detail

MEDICARE: MORGAN ANN GOODALL BCBA

MEDICARE: MORGAN ANN GOODALL BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-20-41483WV

General Provider Information

NPI Number : 1013474048
Entity Type Code : Individual
Provider Name (Legal Business Name) : MORGAN ANN GOODALL BCBA
Provider Business Mailing Address
First Line : 325 6TH AVE
Second Line :
City : SOUTH CHARLESTON
State : WV
Zip : 25303-1231
Country : US
Telephone Number : 304-720-3383
Fax Number :
Provider Business Practice Location Address
First Line : 888 OAKWOOD RD STE 300
Second Line :
City : CHARLESTON
State : WV
Zip : 25314-2071
Country : US
Telephone Number : 681-265-0999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2019
Last Update Date : 06/10/2021

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