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General NPI Number Information
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NPI Number | 1689850174
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Entity Type | Individual
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Provider Name | JENNIFER HUDSON GOSCINSKI MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/14/2008
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Last Update Date | 04/09/2008
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Provider Practice Location Address
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Address Line | 7531 S VIRGINIA DARE TRL SUITE 3A
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City | NAGS HEAD
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State | NC
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Zip | 27959-9162
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Country | US
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Telephone | 252-489-9127
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Fax | 252-480-3127
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Provider Business Mailing Address
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Address Line | PO BOX 268
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City | KITTY HAWK
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State | NC
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Zip | 27949-0268
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Country | US
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Telephone | 252-489-9127
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Fax | 252-480-3127
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C005915
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License Number State | NC
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