Individual
AUTUMN GOFFINET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
27 WILLIAMS AVE, MOGADORE, OH 44260-1137
(330) 608-8874
Mailing address
27 WILLIAMS AVE, MOGADORE, OH 44260-1137
(330) 608-8874
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S.1303511
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
S.1303511
—
OH
Enumeration date
04/23/2019
Last updated
04/23/2019
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