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PENELOPE JEAN GOOCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS LP

Contact information

Practice address
324 W SUPERIOR ST STE 400, DULUTH, MN 55802-1726
(218) 740-3026
(218) 740-3030
Mailing address
324 W SUPERIOR ST STE 400, DULUTH, MN 55802-1726
(218) 740-3026
(218) 740-3030

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3676
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
535S1N0
BCBS
MN
01
6245819
MEDICA UBH
MN
05
805716800
MN
Enumeration date
02/20/2007
Last updated
04/14/2023
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