Provider Demographics
NPI:1699240143
Name:GOFF, BRITTANY DAWN
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:DAWN
Last Name:GOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 SW 7 RD
Mailing Address - Street 2:
Mailing Address - City:STIGLER
Mailing Address - State:OK
Mailing Address - Zip Code:74462-3568
Mailing Address - Country:US
Mailing Address - Phone:918-448-1714
Mailing Address - Fax:
Practice Address - Street 1:1505 E MAIN ST UNIT A
Practice Address - Street 2:
Practice Address - City:STIGLER
Practice Address - State:OK
Practice Address - Zip Code:74462-2914
Practice Address - Country:US
Practice Address - Phone:918-967-3368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator