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Organization
KIMBERLY GOODWIN LCSW-S PLLC
Active
Organization
KIMBERLY GOODWIN LCSW-S PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY SANDRA-LYNN GOODWIN LCSW-S (OWNER)
(210) 857-3096
Entity
Organization
Contact information
Practice address
12119 CHERRY BLOSSOM ST, SAN ANTONIO, TX 78247-4311
(210) 857-3096
Mailing address
12119 CHERRY BLOSSOM ST, SAN ANTONIO, TX 78247-4311
(210) 857-3096
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
378227803
—
TX
Enumeration date
02/25/2021
Last updated
02/25/2021
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