Individual
MR. KENNETH J GOLDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
15431 PICKETT CT, CHESTERFIELD, MO 63017-2427
(314) 614-4393
Mailing address
15431 PICKETT CT, CHESTERFIELD, MO 63017-2427
(314) 614-4393
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
001507
MO
Other
Enumeration date
02/19/2021
Last updated
02/19/2021
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