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General NPI Number Information
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NPI Number | 1003941592
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Entity Type | Individual
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Provider Name | LISA HOPE GOODFRIEND MPT, CWS, FCCWS
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Gender | Female
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7TH AND CLAYTON STREETS ST. FRANCES WOUND CARE CENTER, SUITE 601 MSB
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City | WILMINGTON
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State | DE
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Zip | 19805
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Country | US
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Telephone | 302-575-8180
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Fax | 302-575-8185
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Provider Business Mailing Address
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Address Line | 15 BRIDLE PATH
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City | WILMINGTON
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State | DE
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Zip | 19808-2740
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Country | US
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Telephone | 410-707-9891
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251E1300X
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Taxonomy Name | Clinical Electrophysiology Physical Therapist
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License Number | 19268
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 2251E1300X
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Taxonomy Name | Clinical Electrophysiology Physical Therapist
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License Number | J1-0002084
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License Number State | DE
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