Individual
DR. JEFFREY SAMUEL GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
355 CRAWFORD ST, SUITE 804, PORTSMOUTH, VA 23704-2816
(757) 397-4394
(757) 397-3990
Mailing address
355 CRAWFORD ST, SUITE 804, PORTSMOUTH, VA 23704-2816
(757) 397-4394
(757) 397-3990
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810001065
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007758201
—
VA
Enumeration date
07/07/2006
Last updated
07/08/2007
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