Individual
MS. STEPHANIE ELAINE GOODWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CSAC, QMHP
Contact information
Practice address
915 LAFAYETTE BLVD # C, FREDERICKSBURG, VA 22401-5667
(540) 654-5113
(540) 654-5859
Mailing address
3405 PIPIT DR, ALEXANDRIA, VA 22306-2978
(703) 609-3338
(540) 654-5859
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0710001130
VA
Other
Enumeration date
12/01/2009
Last updated
12/01/2009
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