Individual
JOLIE GOODMAN-LEIBOF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
(505) 925-4031
Mailing address
1 UNIVERSITY NEW MEXICO, ALBUQUERQUE, NM 87131-0001
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
TD-00-76
NM
Other
Enumeration date
03/02/2015
Last updated
07/23/2015
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