Individual
MS. JESSAMYN K GOODWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
55 DOGWOOD LN, WEST FORK, AR 72774-3025
(479) 263-5662
Mailing address
55 DOGWOOD LN, WEST FORK, AR 72774-3025
(479) 263-5662
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A2010142
AR
Other
Enumeration date
08/22/2022
Last updated
08/22/2022
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