Individual
DANITA GODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCSS
Contact information
Practice address
2100 E CHAMBERS DR, BOONEVILLE, MS 38829-8938
(662) 728-3174
Mailing address
P.O BOX 839, CORINTH, MS 38835
(662) 728-2185
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/09/2016
Last updated
03/09/2016
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