Provider Demographics
NPI:1093406753
Name:GOODELL, ZELLA MARION
Entity Type:Individual
Prefix:
First Name:ZELLA
Middle Name:MARION
Last Name:GOODELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 HILL ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-4318
Mailing Address - Country:US
Mailing Address - Phone:781-504-2130
Mailing Address - Fax:
Practice Address - Street 1:11 BOBCAT BLVD
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:NH
Practice Address - Zip Code:03244-7419
Practice Address - Country:US
Practice Address - Phone:603-778-5236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health