Individual
KETASHA GOODWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
377 CLONCE ST, WEBER CITY, VA 24290-7269
(276) 477-5640
Mailing address
269 OAKWOOD AVE, PENNINGTON GAP, VA 24277-2539
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
12/01/2019
Last updated
12/01/2019
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