Individual
DR. VIRGINIA L. GOETSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
755 COMMERCE DR, SUITE 903, DECATUR, GA 30030-2627
(770) 301-3578
Mailing address
PO BOX 2075, DECATUR, GA 30031-2075
(770) 301-3578
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY2269
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000820817C
—
GA
Enumeration date
04/02/2007
Last updated
07/09/2007
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