Individual
SHELLY GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
303 E COURT ST, ATOKA, OK 74525-2047
(580) 889-4717
Mailing address
1414 S WALKER DR, ATOKA, OK 74525-3610
(580) 239-9032
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OK
Other
Enumeration date
10/10/2014
Last updated
10/10/2014
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