| NPI | 1760879910 |
|---|---|
| Former Name | STACEY RENEE GOODING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW60554699) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH I1200679) |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2019-07-15 |