Individual
MISS JENNIFER MICHELLE GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1001 BLYTHE BLVD, SUITE 200, CHARLOTTE, NC 28203-5866
(704) 381-8388
Mailing address
1001 BLYTHE BLVD, SUITE 200, CHARLOTTE, NC 28203-5866
(704) 381-8388
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86058389
NC
Other
Enumeration date
03/02/2017
Last updated
03/02/2017
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