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NPI 1104448612

IndividualActive

Brandon Goodly

NPI 1104448612 · Peer Specialist · Lake Charles, LA

Provider details

NPI number: 1104448612
Entity type: Individual
Primary specialty: Peer SpecialistOther Service Providers
Sex: Male
Sole proprietor: No

Practice location

751 Bayou Pines East Dr Ste C

Lake Charles, LA 70601-7196

Phone: (337) 433-3292

More LA providers

Mailing address

8326 Kelwood Ave

Baton Rouge, LA 70806-4803

Registry dates

Enumerated: 2020-05-07
Last updated: 2020-05-07

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Brandon Goodly — NPI 1104448612, Lake Charles, LA | NPI Central