Individual
MRS. TRACI GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
504 WYNRIDGE CT, MADISON, MS 39110-8461
(601) 720-9915
Mailing address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 362-4471
(601) 368-4483
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
719520
—
Other
Enumeration date
05/05/2009
Last updated
09/10/2025
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