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NPI Code Detail

MEDICARE: MRS. JADE GOODIEL

MEDICARE:  MRS. JADE  GOODIEL
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
1106S00000XBehavior TechnicianAL

General Provider Information

NPI Number : 1467389882
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JADE GOODIEL
Provider Business Mailing Address
First Line : 4950 GOVERNMENT BLVD APT 186
Second Line :
City : MOBILE
State : AL
Zip : 36693-5017
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 209 20TH ST N
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35203-3644
Country : US
Telephone Number : 855-832-6727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2026
Last Update Date : 05/07/2026

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Directions to “ MRS. JADE GOODIEL ” Practice Location

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