Individual
TIFFANY GOOSBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
811 N 9TH AVE, DURANT, OK 74701-3727
(580) 634-1432
Mailing address
811 N 9TH AVE, DURANT, OK 74701-3727
(580) 634-1432
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
3747P1801X
Personal Care Attendant
—
OK
Other
Enumeration date
04/04/2023
Last updated
04/04/2023
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