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Individual

DR. JERALD M GOTTLIEB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D

Contact information

Practice address
7 OGLETHORPE PROFESSIONAL BLVD, UNIT 3, SAVANNAH, GA 31406-3608
(912) 224-5841
(912) 352-4220
Mailing address
7 OGLETHORPE PROFESSIONAL BLVD, UNIT 3, SAVANNAH, GA 31406-3608
(912) 224-5841
(912) 352-4220

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY002692
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
663871593A
GA
Enumeration date
06/16/2006
Last updated
09/15/2021
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