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NPI Profile for JASON H GOODWIN in COEUR D'ALENE, ID.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X |
| NPI Number | 1174621627 |
|
| Status | Active | |
| Credentials | LCPC, CDAC | |
| Entity | Individual | |
| Enumeration date | 09/20/2006 | |
| Last updated | 08/04/2011 - About 15 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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JASON H GOODWIN
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JASON H GOODWIN, LCPC, CDAC