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Individual

GOLDWIN WANIDA PENNING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
990 S DIXIE BLVD, RADCLIFF, KY 40160-1289
(859) 254-1035
Mailing address
829 MAGNOLIA DR, RADCLIFF, KY 40160-2968

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7101025010
KY
Enumeration date
10/14/2024
Last updated
01/09/2025
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