Individual
ELLEN AMMEN GOOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
93 GARDEN DR, OSWEGO, NY 13126-6103
(910) 374-9225
Mailing address
93 GARDEN DR, OSWEGO, NY 13126-6103
(910) 374-9225
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
077240
NY
1041C0700X
Clinical Social Worker
077240
NC
Other
Enumeration date
09/06/2007
Last updated
01/02/2024
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