Provider Demographics
NPI:1871769620
Name:GOODNER, PAULA JEAN (MED,LPC)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:JEAN
Last Name:GOODNER
Suffix:
Gender:F
Credentials:MED,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2009 TEXOMA PKWY
Mailing Address - Street 2:SUITE3
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-2687
Mailing Address - Country:US
Mailing Address - Phone:903-892-2874
Mailing Address - Fax:903-891-9064
Practice Address - Street 1:2009 TEXOMA PKWY
Practice Address - Street 2:SUITE3
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-2687
Practice Address - Country:US
Practice Address - Phone:903-892-2874
Practice Address - Fax:903-891-9064
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15759101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional