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Individual

KATHY ANN GOODWIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4206 DANTZLER ST, MOSS POINT, MS 39563-2218
(228) 623-2303
(228) 475-1976
Mailing address
4206 DANTZLER ST, MOSS POINT, MS 39563-2218
(228) 623-2303
(228) 475-1976

Taxonomy

Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary

Other

Enumeration date
06/20/2022
Last updated
06/20/2022
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