| Virginia L. Goetsch, Ph.d. | |
|
775 Commerce Dr Suite 903 Decatur GA 30030-2620 | |
| (770) 301-3578 | |
| (404) 638-5293 |
| Full Name | Virginia L. Goetsch, Ph.d. |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 775 Commerce Dr, Decatur, Georgia |
| Authorized Official Name and Position | Virginia L Goetsch (PRESIDENT) |
| Authorized Official Contact | 7703013578 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Virginia L. Goetsch, Ph.d. 5282 Hickory Walk Ter Sw Conyers GA 30094-4757 Ph: (770) 301-3578 | Virginia L. Goetsch, Ph.d. 775 Commerce Dr Suite 903 Decatur GA 30030-2620 Ph: (770) 301-3578 |
| NPI Number | 1407105703 |
|---|---|
| Provider Enumeration Date | 08/31/2012 |
| Last Update Date | 11/01/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407105703 | NPI | - | NPPES |
| 11511070 | Other | GA | CAQH |
| 000820817C | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 2269 (Georgia) | Primary |
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