Organization
ANDERSON DISTRICT 4
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS WAYNE GOODWIN LPES (DIRECTOR OF SPECIAL EDUCATION)
(864) 403-2000
Entity
Organization
Contact information
Practice address
315 E QUEEN ST, PENDLETON, SC 29670-1721
(864) 403-2000
(864) 403-2099
Mailing address
315 E QUEEN ST, PENDLETON, SC 29670-1721
(864) 403-2000
(864) 403-2099
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
3046
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0404
—
SC
Enumeration date
12/26/2012
Last updated
12/26/2012
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