Individual
DAWN GOFORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
913 N CAROLINA AVE, STATESVILLE, NC 28677-3414
(704) 871-0934
Mailing address
4575 SE DIXIE HWY, STUART, FL 34997-6826
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
247200000X
Other Technician
—
—
Other
Enumeration date
08/19/2019
Last updated
04/25/2021
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