Individual
MARY S GOODWYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
415 N JACKSON ST, AMERICUS, GA 31709-3015
(229) 931-2470
Mailing address
415 N JACKSON ST, AMERICUS, GA 31709
(229) 931-4425
(229) 931-2474
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC002261
GA
Other
Enumeration date
03/07/2012
Last updated
03/07/2012
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