Individual
MRS. JESSICA Y GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
252 JAMES ST, FAIRFIELD, CT 06824-6475
(917) 623-7765
(917) 210-3426
Mailing address
252 JAMES ST, FAIRFIELD, CT 06824
(917) 623-7765
(917) 210-3426
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
007879
CT
1041C0700X
Clinical Social Worker
Primary
067458
NY
Other
Enumeration date
05/06/2010
Last updated
12/18/2015
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