| Doctor Name: | DR. MISTY GOFFENA |
| NPI Number: | 1073761623 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSYD |
| License Number: | |
| Business Practice Address: | 415 S Walnut St Ste. 215 Seymour, IN - 472742991 |
| Business Phone Number: | 8125230386 |
| Business Fax Number: | |
| Mailing Address: | 415 S Walnut St, Ste. 215 SEYMOUR |
| State: | IN |
| Postal Code: | 472742991 |
| Phone Number: | 8125230386 |
| Fax Number: | |
| NPI Enumeration Date: | 09/08/2008 |
| NPI Last Update Date: | 09/08/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |