Individual
AVERY GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
6810 FORT JACKSON CT, MILTON, FL 32583-7692
(850) 503-6636
(850) 626-6132
Mailing address
6810 FORT JACKSON CT, MILTON, FL 32583-7692
(850) 503-6636
(850) 626-6132
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-21-11965
—
106S00000X
Behavior Technician
RBT-20-110822
FL
Other
Enumeration date
01/27/2020
Last updated
04/02/2021
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