Individual
EBONY GOODSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3971 SOUTHEASTERN WAY, WEST COLUMBIA, SC 29169-2442
(803) 422-9815
Mailing address
2815 PEACH ST, CAYCE, SC 29033-2731
(803) 422-9815
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
—
—
374U00000X
Home Health Aide
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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