Individual
MISS JENNIFER GODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2460 INDIA HOOK RD STE AND105, ROCK HILL, SC 29732-3530
(803) 366-6250
(803) 905-4431
Mailing address
181 W PROFESSIONAL PARK CT STE 1, BOWLING GREEN, KY 42104-3250
(270) 777-9283
(270) 777-9283
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-6-3183
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
EX6562
—
SC
Enumeration date
05/22/2007
Last updated
03/17/2018
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