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General NPI Number Information
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NPI Number | 1770660177
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Entity Type | Individual
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Provider Name | DEBRA L GOFFINET M. A. CCC-A
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Gender | Female
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/19/2015
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Provider Practice Location Address
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Address Line | 1602 N 2ND ST
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City | CLINTON
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State | MO
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Zip | 64735-1192
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Country | US
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Telephone | 660-885-8171
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Fax | 660-890-8499
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Provider Business Mailing Address
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Address Line | 1602 N 2ND ST UNIT 5-260
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City | CLINTON
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State | MO
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Zip | 64735-1192
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Country | US
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Telephone | 660-885-8171
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Fax | 660-890-8499
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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 | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 109607
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License Number State | MO
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