| NPI | 1174640387 |
|---|---|
| Former Name | JESSICA GOODWIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.012581) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IL 150010352) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2013-06-24 |