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1144519398
FARA DIANE GOODWYN
BRYAN, TX
NPI
1144519398
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
103K00000X Behavior Analyst
(Licence: TX 1-10-7377)
Enumeration Date
2011-03-28
Last Update Date
2011-03-28
Business Address
Mrs. FARA DIANE GOODWYN M.Ed., BCBA
1318 MEMORIAL DR
BRYAN, TX 77802-5215
Phone number: 979-776-2872
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Mailing Address
Mrs. FARA DIANE GOODWYN M.Ed., BCBA
1413 ANGELINA CIR
COLLEGE STATION, TX 77840-4952
Phone number: 979-229-4815
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