Provider Information for 1912697756
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
Mrs. JENNA MARIE GODDEYNE LPC
Sex: Female
NPI: 1912697756
Last Updated: 2023-05-12
Certification Date: 2023-05-12
Certification Date: 2023-05-12
Details
Name | Value | ||||||||
---|---|---|---|---|---|---|---|---|---|
NPI | 1912697756 | ||||||||
Enumeration Date | 2023-05-12 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | NO | ||||||||
Status | Active | ||||||||
Mailing Address | 204 OLDE SCHOOL RD NEENAH, WI 54956-6113 United States Phone: 920-585-0434 | Fax: | ||||||||
Primary Practice Address | 204 OLDE SCHOOL RD NEENAH, WI 54956-6113 United States Phone: 920-585-0434 | Fax: | ||||||||
Secondary Practice Address(es) | |||||||||
Health Information Exchange |
| ||||||||
Other Identifiers |
| ||||||||
Taxonomy |
|