MRS. Stacey P Goodman, COTA

NPI #1568639490 in South Bend, Indiana

Provider Information

NPI Number: 1568639490
Entity Type: Individual
Name: MRS. Stacey P Goodman, COTA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: COTA
Enumeration Date: May 9, 2008
Last Updated: May 9, 2008

Practice Location

Address: 926 E WAYNE ST
City: South Bend
State: Indiana
ZIP Code: 46617-3000
Phone: (574) 233-8812

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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