Individual
RONI LEE GOLDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
315 E QUEEN ST, PENDLETON, SC 29670-1721
(864) 403-2071
Mailing address
315 E QUEEN ST, PENDLETON, SC 29670-1721
(864) 403-2071
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
8515
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942275649
—
SC
Enumeration date
02/25/2013
Last updated
02/25/2013
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