Provider Demographics
NPI:1356609531
Name:GOFF, ANNE M (MS CCC SLP)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:M
Last Name:GOFF
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1700 EAST BARNETT ROAD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-0052
Mailing Address - Country:US
Mailing Address - Phone:541-773-8255
Mailing Address - Fax:541-773-8256
Practice Address - Street 1:1700 EAST BARNETT ROAD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-0052
Practice Address - Country:US
Practice Address - Phone:541-773-8255
Practice Address - Fax:541-773-8256
Is Sole Proprietor?:No
Enumeration Date:2012-04-25
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10807235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist