Provider Demographics
NPI:1477524478
Name:GOLTZMAN, RACHEL E (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:E
Last Name:GOLTZMAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7328 BRUNO AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-2410
Mailing Address - Country:US
Mailing Address - Phone:314-517-7059
Mailing Address - Fax:314-646-1089
Practice Address - Street 1:1735 S NEW FLORISSANT RD
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-8309
Practice Address - Country:US
Practice Address - Phone:314-517-7059
Practice Address - Fax:314-646-1089
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20001613901041C0700X
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical