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General NPI Number Information
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NPI Number | 1992318380
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Entity Type | Organization
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Legal Business Name | DR TINA GOODIN ENTERPRISES INC
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Dates
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Enumeration Date | 08/26/2020
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Last Update Date | 08/26/2020
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Provider Practice Location Address
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Address Line | PSYCHOLOGY CENTER OF PALM BEACH 249 ROYAL PALM WAY
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City | PALM BEACH
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State | FL
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Zip | 33480
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Country | US
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Telephone | 561-301-1464
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Fax |
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Provider Business Mailing Address
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Address Line | 249 ROYAL PALM WAY STE 301
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City | PALM BEACH
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State | FL
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Zip | 33480-4333
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Country | US
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Telephone | 978-455-9332
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Fax |
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Authorized Official
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Title or Position | OFFICE /BILLING MANAGER
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Name | SHARON PIMENTEL
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Credential |
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Telephone | 978-455-9332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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