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
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.