Individual
PENNY GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
10645 N TATUM BLVD STE 200-370, PHOENIX, AZ 85028-3068
(480) 810-9020
Mailing address
10645 N TATUM BLVD STE 200-370, PHOENIX, AZ 85028-3068
(480) 810-9020
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-2926
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
736720
—
AZ
Enumeration date
03/28/2006
Last updated
06/28/2023
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