Organization
JERALD M. GOTTLIEB, PH.D, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERALD M GOTTLIEB PH.D (PSYCHOLOGIST)
(912) 224-5841
Entity
Organization
Contact information
Practice address
7 OGLETHORPE PROFESSIONAL BLVD STE 3, SAVANNAH, GA 31406-3677
(912) 224-5841
(912) 352-4220
Mailing address
7 OGLETHORPE PROFESSIONAL BLVD STE 3, SAVANNAH, GA 31406-3677
(912) 224-5841
(912) 352-4220
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY002692
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1972548907
NPI
GA
05
—
663871593A
—
GA
Enumeration date
09/17/2009
Last updated
10/29/2021
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