Individual
SHANAE GOOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1811 COLLEGE AVE SE, GRAND RAPIDS, MI 49507-2621
(616) 236-3074
Mailing address
1811 COLLEGE AVE SE, GRAND RAPIDS, MI 49507-2621
(616) 375-6868
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
12/18/2016
Last updated
12/18/2016
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