Provider Demographics
NPI:1992318380
Name:DR TINA GOODIN ENTERPRISES INC
Entity type:Organization
Organization Name:DR TINA GOODIN ENTERPRISES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE /BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:PIMENTEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-455-9332
Mailing Address - Street 1:249 ROYAL PALM WAY STE 301
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33480-4333
Mailing Address - Country:US
Mailing Address - Phone:978-455-9332
Mailing Address - Fax:
Practice Address - Street 1:PSYCHOLOGY CENTER OF PALM BEACH
Practice Address - Street 2:249 ROYAL PALM WAY
Practice Address - City:PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33480
Practice Address - Country:US
Practice Address - Phone:561-301-1464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty