Most Relevant Information
Provider Data
| NPI Number: | 1003389602 |
| Provider Name: | MICHELLE ANTOINETTE GOINES LCSW-C |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 23409 |
Most Important Dates
| Enumeration Date: | 01/07/2019 |
| Last Updated: | 03/11/2019 |
Provider Practice Location
1522 N ELLAMONT ST
BALTIMORE
MD
21216
Practice Location Phone/Fax
| Phone: | 4104199823 |
| Fax: |
Provider Mailing Location
1522 N ELLAMONT ST
BALTIMORE
MD
212163817
Provider Mailing Phone/Fax
| Phone: | 4104199823 |
| Fax: |