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Individual

VIOLET M GOODWINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S.W.

Contact information

Practice address
121 S 4TH ST, THERMOPOLIS, WY 82443-2634
(307) 864-3138
(307) 864-3139
Mailing address
121 S 4TH ST, THERMOPOLIS, WY 82443-2634
(307) 864-3138
(307) 864-3139

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
PPC # 178
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
108969204
WY
05
108969205
WY
05
132369500
WY
Enumeration date
05/08/2007
Last updated
07/16/2014
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