Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 6801057609 | MI |
NPI | 1003057217 |
---|---|
Provider Name | Shari-Beth Goldman |
First Address | West Bloomfield, MI 48322-4926 |
Second Address | West Bloomfield, MI 48322-4926 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2009 |
Last Update Date | 18/03/2009 |