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Individual

FRANCES R. GOFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
11104 PARKVIEW CIRCLE DR STE 110, FORT WAYNE, IN 46845-1730
(260) 460-3100
(260) 460-3130
Mailing address
11104 PARKVIEW CIRCLE DR STE 110, FORT WAYNE, IN 46845-1730
(260) 460-3100
(260) 460-3130

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
20040766A
IN
103TC0700X
Clinical Psychologist
20040766A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200263250
IN
05
2169317
OH
01
680012060
RR MEDICARE
IN
Enumeration date
06/30/2005
Last updated
02/21/2013
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