Individual
STEFANIE A GOODRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
100 MARTIN LUTHER KING JR BLVD, WORCESTER, MA 01680-1209
(508) 754-3823
(508) 753-0151
Mailing address
100 MARTIN LUTHER KING JR BLVD, WORCESTER, MA 01680-1209
(508) 754-3823
(508) 753-0151
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
1875
MA
363A00000X
Physician Assistant
Primary
PA1875
MA
Other
Enumeration date
11/03/2005
Last updated
02/13/2021
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