Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | ||
N | 225XM0800X | Mental Health |
NPI | 1598302424 |
---|---|
Provider Name | Taylor R Goshe |
First Address | Tiffin, OH 44883-9704 |
Second Address | Tiffin, OH 44883-9704 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2019 |
Last Update Date | 01/09/2021 |