Doctor Name: | JENNIFER JEAN GOERGER |
NPI Number: | 1740416932 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICSW |
License Number: | 15320 |
Business Practice Address: | 450 5th St Sw Ste 100 Milaca, MN - 563531349 |
Business Phone Number: | 3202600257 |
Business Fax Number: | |
Mailing Address: | 450 5th St Sw, Ste 100 MILACA |
State: | MN |
Postal Code: | 563531349 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/02/2009 |
NPI Last Update Date: | 06/02/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 15320 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |