Individual
MRS. LATANYA GOODWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
558 MISSION RD, WINSTON SALEM, NC 27103-1708
(502) 319-0455
Mailing address
558 MISSION RD, WINSTON SALEM, NC 27103-1708
(502) 319-0455
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
—
—
Other
Enumeration date
04/11/2015
Last updated
10/08/2015
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