Individual
JENNIFER GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW, MED
Contact information
Practice address
3550 MARKET ST RM 3066, PHILADELPHIA, PA 19104-3329
(215) 590-0702
Mailing address
3550 MARKET ST RM 3066, PHILADELPHIA, PA 19104-3329
(215) 590-0702
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW127729
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1029097310001
—
PA
Enumeration date
11/25/2019
Last updated
11/25/2019
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