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General NPI Number Information
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NPI Number | 1518950252
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Entity Type | Individual
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Provider Name | JUDY T. GOFFI RD
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Gender | Female
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Dates
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Enumeration Date | 08/29/2005
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Last Update Date | 06/25/2019
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Provider Practice Location Address
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Address Line | 7211 BANK CT
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City | FREDERICK
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State | MD
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Zip | 21703-8483
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Country | US
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Telephone | 240-566-7830
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 37086
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City | BALTIMORE
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State | MD
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Zip | 21297-3086
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Country | US
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Telephone | 301-714-4041
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Fax | 301-714-4351
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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 | 133VN1006X
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Taxonomy Name | Metabolic Nutrition Registered Dietitian
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License Number | D02101
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License Number State | MD
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