Individual
MS. DENISE M GOFORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5016 N UNIVERSITY ST, SUITE 105, PEORIA, IL 61614-4781
(309) 692-7778
(309) 692-7779
Mailing address
5016 N UNIVERSITY ST, SUITE 105, PEORIA, IL 61614-4781
(309) 692-7778
(309) 692-7779
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149-000026
IL
Other
Enumeration date
08/15/2006
Last updated
12/20/2019
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