Individual
DESTINY GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
41 GOLDEN ACRE CT, SIMPSONVILLE, SC 29681-3264
(864) 688-9973
Mailing address
41 GOLDEN ACRE CT, SIMPSONVILLE, SC 29681-3264
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5481
SC
Other
Enumeration date
01/05/2023
Last updated
01/05/2023
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