Jason Goodijohn
Adult Companion in Palmyra, NE. Individual provider (NPI-1).
NPI number1477367290
StatusActive
Last updated in NPPESFeb 3, 2025
Details
- NPI
- 1477367290
- Entity type
- Individual (NPI-1)
- Name
- Mr. Jason Goodijohn
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 3, 2025
- Certification date
- Feb 3, 2025
- Last updated
- Feb 3, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 372600000X | Adult Companion | – | NE | Yes |
| 171W00000X | Contractor | – | NE |
Practice location
982 N 10th RdPalmyra, NE 68418-4012
Phone 402-740-1270
Mailing address
982 N 10th RdPalmyra, NE 68418-4012
Phone 402-740-1270
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