Miracle Nicole Goetz
Clinical Child & Adolescent Psychologist
1044 Sw 4th St
Moore
, Oklahoma 73160-2405
Miracle Nicole Goetz
Clinical Child & Adolescent Psychologist
1044 Sw 4th St
Moore
, Oklahoma 73160-2405
(405) 735-6629
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About
Features
Specialties
- Clinical Child & Adolescent Psychologist
Languages spoken
- English
Location
First Address
- Miracle Nicole Goetz
- 1044 Sw 4th St
- Moore, OK
- Zip : 73160-2405
- Fax : (405) 735-6629
- Phone : (405) 735-6333
Second Address
- Miracle Nicole Goetz
- 1044 Sw 4th St
- Moore, OK
- Zip : 73160-2405
- Fax : (405) 735-6629
- Phone : (405) 735-6333
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103TC2200X | Clinical Child & Adolescent Psychologist |
National Provider Identifier
| NPI | 1083881189 |
|---|---|
| Provider Name | Miracle Nicole Goetz |
| First Address | Moore, OK 73160-2405 |
| Second Address | Moore, OK 73160-2405 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/05/2008 |
| Last Update Date | 09/06/2015 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.