Provider Demographics
NPI:1124590351
Name:GOGGINS, CLAIRE M (RD, LDN)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:M
Last Name:GOGGINS
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:M
Other - Last Name:FORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LDN
Mailing Address - Street 1:PO BOX 776084
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-4485
Mailing Address - Country:US
Mailing Address - Phone:366-893-1356
Mailing Address - Fax:636-893-1358
Practice Address - Street 1:15945 CLAYTON RD STE 310
Practice Address - Street 2:
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63011-2493
Practice Address - Country:US
Practice Address - Phone:636-893-1356
Practice Address - Fax:636-893-1358
Is Sole Proprietor?:No
Enumeration Date:2018-12-28
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered