Individual
MS. DIANA GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
315 N ACADEMY ST, 253, CARY, NC 27513-4540
(919) 467-3692
Mailing address
7029 INDIAN WELLS RD, CARY, NC 27519-2520
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1548
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36189
BCBSNC
NC
05
—
7436189
—
NC
Enumeration date
07/31/2007
Last updated
07/31/2007
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