Individual
MS. JENIENNE ELIZABETH GOODEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1674 SOUTH EAST FALLON DRIVE, PORT ST. LUCIE, FL 34983
(772) 834-5733
Mailing address
1674 SOUTHEAST FALLON DRIVE, PORT ST. LUCIE, FL 34983
(772) 834-5733
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
04/08/2022
Last updated
04/08/2022
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