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Individual

TANIESA L. GOODMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4931 WISSAHICKON AVE FL 3, PHILADELPHIA, PA 19144-4800
(215) 385-5122
Mailing address
210 W CRYSTAL LAKE AVE APT 253D, HADDONFIELD, NJ 08033-3245

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
PA

Other

Enumeration date
02/09/2026
Last updated
02/09/2026
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