Healthcare Provider Details

I. General information

NPI: 1356477137
Provider Name (Legal Business Name): JOANNA L. GOOD PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MADISON AVE DDC
MORRISTOWN NJ
07960-6136
US

IV. Provider business mailing address

100 MADISON AVE DDC
MORRISTOWN NJ
07960-6136
US

V. Phone/Fax

Practice location:
  • Phone: 973-971-5302
  • Fax: 973-290-7172
Mailing address:
  • Phone: 973-971-5302
  • Fax: 973-290-7172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number35S100414100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: