Provider Demographics
NPI:1114119419
Name:GOFF, ADRIANNE (SLP)
Entity Type:Individual
Prefix:MS
First Name:ADRIANNE
Middle Name:
Last Name:GOFF
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 COMMERCIAL WAY
Mailing Address - Street 2:
Mailing Address - City:FALLON
Mailing Address - State:NV
Mailing Address - Zip Code:89406-2600
Mailing Address - Country:US
Mailing Address - Phone:775-867-3904
Mailing Address - Fax:775-867-3901
Practice Address - Street 1:52 COMMERCIAL WAY
Practice Address - Street 2:
Practice Address - City:FALLON
Practice Address - State:NV
Practice Address - Zip Code:89406-2600
Practice Address - Country:US
Practice Address - Phone:775-867-3904
Practice Address - Fax:775-867-3901
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-1157235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist