Individual provider · Type 1 NPI

Stacey P. Goodman, COTA

Specialist · South Bend, IN

NPI number 1568639490 Active

Practice location

926 E Wayne St
South Bend, IN 46617-3000

Call (574) 233-8812 Map

Fax (574) 233-8873

Mailing address

10379 Edison Rd
Osceola, IN 46561-9355

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000X32000767A (IN)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1568639490

Stacey P. Goodman, COTA's National Provider Identifier is 1568639490, issued on May 9, 2008. The primary taxonomy on file is Specialist (174400000X), and the practice location is in South Bend, IN. The record was last updated on May 9, 2008.