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Individual

TIFFANY NICOLE GODWIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
15411 W WADDELL RD STE 102-1073, SURPRISE, AZ 85379-5170
(850) 739-2332
(623) 632-0097
Mailing address
15411 W WADDELL RD STE 102-1073, SURPRISE, AZ 85379-5170
(850) 739-2332
(623) 632-0097

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103TC0700X
Clinical Psychologist
Primary
PSY005014
AZ

Other

Enumeration date
06/01/2007
Last updated
07/13/2022
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