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1063654325
TARA GOODWYN
MERCED, CA
NPI
1063654325
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
(Licence: CA 226748)
Enumeration Date
2009-04-01
Last Update Date
2009-04-01
Business Address
TARA GOODWYN LVN
300 E 15TH ST
MERCED, CA 95341-6217
Phone number: 209-381-6879
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Mailing Address
TARA GOODWYN LVN
300 E 15TH ST
MERCED, CA 95341-6217
Phone number: 209-381-6879
Copy
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