Individual
LONELLE TAYVON GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
875 BERKSHIRE BLVD STE 106, READING, PA 19610-1246
(302) 334-8669
Mailing address
875 BERKSHIRE BLVD STE 106, READING, PA 19610-1246
(484) 797-9366
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
31160479
PA
Other
Enumeration date
02/23/2026
Last updated
02/23/2026
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