Individual
DONNAL BLAKE GOODWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
116 MCCARDELL LN, LIVINGSTON, TX 77351-3347
(936) 239-3308
Mailing address
116 MCCARDELL LN, LIVINGSTON, TX 77351-3347
(936) 239-3308
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
125127
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19091795
DRIVES LICENSE
TX
01
—
209855
TBOTE CERTIFICATION
TX
01
—
221830
NBCOT LICENSE
TX
Enumeration date
12/17/2018
Last updated
06/06/2025
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