Individual
MR. JEREMIAH GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2050A 2ND ST SE, KIRTLAND AFB, NM 87117-5003
(505) 846-3200
Mailing address
2050A 2ND ST SE, KIRTLAND AFB, NM 87117-5901
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW018748
PA
Other
Enumeration date
07/30/2013
Last updated
08/04/2021
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