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1770654360
STACI LYN GOFTON
ALLEGAN, MI
NPI
1770654360
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MI 6801085687)
Enumeration Date
2006-11-13
Last Update Date
2007-07-08
Business Address
Miss STACI LYN GOFTON LMSW
3285 122ND AVE
ALLEGAN, MI 49010-9511
Phone number: 269-673-6617
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Mailing Address
Miss STACI LYN GOFTON LMSW
560 PARKSIDE AVE NW
GRAND RAPIDS, MI 49534-3411
Phone number:
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