Individual
DELLA GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
440 E TAMPA ST, SPRINGFIELD, MO 65806-1131
(417) 831-0150
(417) 831-0155
Mailing address
PO BOX 5681, SPRINGFIELD, MO 65801-5681
(417) 831-0150
(417) 831-0155
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
000639
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
493299036
—
MO
Enumeration date
06/24/2005
Last updated
10/28/2009
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