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Individual
JON W GOODWIN III
Active
Individual
JON W GOODWIN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
090186
IA
103T00000X
Psychologist
32003
CA
103TC0700X
Clinical Psychologist
090186
IA
103TC2200X
Clinical Child & Adolescent Psychologist
090186
IA
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
32003
CA
Other
Enumeration date
08/30/2018
Last updated
07/27/2023
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