Individual
MS. CRYSTAL R GOFORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4374 EVANGELINE LN, LEXINGTON, KY 40509-6901
(859) 684-2220
Mailing address
4374 EVANGELINE LN, LEXINGTON, KY 40509-6901
(859) 684-2220
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
10/14/2013
Last updated
10/14/2013
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