Individual
EDWINA GOOMBI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
804 W CHOCTAW AVE, CHICKASHA, OK 73018-2310
(405) 424-7711
Mailing address
514 EAST GRACEMONT ST, GRACEMONT, OK 73042
(405) 648-2291
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/28/2022
Last updated
10/28/2022
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