Individual
THEODORE MICHAEL GOETZ
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1751 S LUMPKIN ST, ATHENS, GA 30606-4740
(706) 548-9441
(706) 354-8904
Mailing address
1751 S LUMPKIN ST, ATHENS, GA 30606-4740
(706) 548-9441
(706) 354-8904
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
698
GA
Other
Enumeration date
10/31/2005
Last updated
07/08/2007
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