Individual
GENNIFER MICHELLE GOODLOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2916 CLAIRMONT RD NE, BROOKHAVEN, GA 30329-4441
(312) 257-9500
Mailing address
2916 CLAIRMONT RD NE APT 3212, BROOKHAVEN, GA 30329-4492
(312) 257-9500
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
149018751
IL
1041C0700X
Clinical Social Worker
Primary
CSW007128
GA
Other
Enumeration date
01/04/2021
Last updated
01/04/2021
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