Individual
THOMAS WAYNE GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPES
Contact information
Practice address
315 E QUEEN ST, PENDLETON, SC 29670-1721
(864) 403-2000
(864) 403-2099
Mailing address
315 E QUEEN ST, PENDLETON, SC 29670-1721
(864) 403-2000
(864) 403-2099
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
3046
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942275649
—
SC
Enumeration date
01/09/2013
Last updated
09/18/2013
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