Tera Goodman

Individual provider Active NPI Developmental Disabilities Clinic/Center · Hardy, AR

NPI 1215348552 · NPPES record last updated May 8, 2014

Key facts

NPI
1215348552
Entity type
Individual (NPI type 1)
Primary specialty
Developmental Disabilities Clinic/Center 261QD1600X
Practice address
15 Barber Dr
Hardy, AR 72542-9109
Phone
(870) 994-3103
NPI assigned
May 8, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X Yes

Addresses

Primary practice location

15 Barber Dr
Hardy, AR 72542-9109

Mailing address

15 Barber Dr
Hardy, AR 72542-9109

Other providers in Hardy, AR

All providers in Hardy, AR · Developmental Disabilities Clinic/Center in Arkansas

Sources for this page

Verify at the official NPI Registry.