Individual
MS. JANE B GOTSHALK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
109 COURAGE LOOP, FORT STEWART, GA 31315-5906
(706) 315-9407
Mailing address
109 COURAGE LOOP, FORT STEWART, GA 31315-5906
(706) 315-9407
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LICSW113296
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1309587
—
MA
Enumeration date
05/18/2007
Last updated
05/17/2024
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