| NPI | 1770718678 |
|---|---|
| Former Name | MELISSA JANE GOODWIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11007220) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9320462) |
| 225700000X Massage Therapist (Licence: FL MA35203) | |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2021-10-26 |