Daranna Elisa Goodwin

Individual provider Active NPI Behavior Technician · Beaumont, TX

NPI 1992448484 · NPPES record last updated Apr 14, 2022

Key facts

NPI
1992448484
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
7485 Phelan Blvd
Beaumont, TX 77706-5748
Phone
(346) 333-1902
NPI assigned
Apr 14, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

7485 Phelan Blvd
Beaumont, TX 77706-5748

Mailing address

7485 Phelan Blvd
Beaumont, TX 77706-5748
Phone (346) 333-1902

Other providers in Beaumont, TX

All providers in Beaumont, TX · Behavior Technician in Texas

Sources for this page

Verify at the official NPI Registry.