Individual
MRS. CONTESSA LEE GOODWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PROVIDER
Contact information
Practice address
151 MICHIGAN AVE, WILMINGTON, OH 45177-1352
(937) 655-7432
Mailing address
151 MICHIGAN AVE, WILMINGTON, OH 45177-1352
(937) 655-7432
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2664791
STATE PROVIDER NUMBER
OH
Enumeration date
05/09/2007
Last updated
07/08/2007
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