Individual
MS. JEROLYN MAE GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.N., L.D.
Contact information
Practice address
1405 MERCEDES ST, BENBROOK, TX 76126-2809
(817) 249-2423
Mailing address
1405 MERCEDES ST, BENBROOK, TX 76126-2809
(817) 249-2423
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT84176
TX
Other
Enumeration date
08/11/2016
Last updated
08/11/2016
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