Goodman, Stacey P

Goodman, Stacey P is an sole proprietor health care provider with primary practice located at 926 E Wayne St , South Bend IN 46617-3000. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Goodman, Stacey P can be contacted via phone (574) 233-8812.

Contact Information

Primary practice address
926 E Wayne St South Bend IN 46617-3000
Fax: (574) 233-8873
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 32000767A Indiana

Profile Details

NPI number 1568639490
LBN Legal business name Goodman, Stacey P
Credentials Certified Occupational Therapy Assistant (COTA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 9th, 2008
Last updated May 9th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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