Individual
JESSICA BROOKE GOTTLIEB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
500 S BROAD ST STE 380, PHILADELPHIA, PA 19146-1613
(215) 685-6600
Mailing address
1622 S 12TH ST, PHILADELPHIA, PA 19148-1002
(856) 816-6106
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW020958
PA
Other
Enumeration date
01/13/2021
Last updated
01/13/2021
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