Provider Demographics
NPI:1770941650
Name:GOODMAN, DONNA L (MS, BCBA, LBA)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:L
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:MS, BCBA, LBA
Other - Prefix:MS
Other - First Name:DONNA
Other - Middle Name:
Other - Last Name:TOWNLEY-COCHRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, BCBA
Mailing Address - Street 1:8260 PRECINT LINE RD
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76182
Mailing Address - Country:US
Mailing Address - Phone:817-717-6060
Mailing Address - Fax:713-962-4599
Practice Address - Street 1:8260 PRECINT LINE RD
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76182
Practice Address - Country:US
Practice Address - Phone:817-717-6060
Practice Address - Fax:713-962-4599
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-05
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1201103K00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst