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Individual

ROSAMOND ELLIS GOUDEAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
179 PIERCE AVE, MACON, GA 31204-2821
(478) 742-1464
(478) 742-1883
Mailing address
175 EMERY HIGHWAY, MACON, GA 31217
(478) 751-4446
(478) 751-4444

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
001410
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001410
LCSW
GA
Enumeration date
10/06/2006
Last updated
01/11/2021
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