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Individual

HEATHER LYNN GOOCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2720 SAN PEDRO DR NE, ALBUQUERQUE, ALBUQUERQUE, NM 87110-3333
(505) 265-7936
(505) 265-9685
Mailing address
2720 SAN PEDRO DR NE, ALBUQUERQUE, ALBUQUERQUE, NM 87110-3333
(505) 265-7936
(505) 265-9685

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
172V00000X
Community Health Worker

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
D3124
NM
Enumeration date
03/12/2010
Last updated
03/12/2010
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