Individual
MS. TRACEY JAVELLE GOODSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED
Contact information
Practice address
112 N BROAD ST, PHILA, PA 19102-1510
(215) 568-0860
(215) 568-0769
Mailing address
7118 LIMEKILN PIKE, PHILA, PA 19138-2025
(215) 924-5129
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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