Provider Demographics
NPI:1336389089
Name:PACHT-GOODMAN, JENNIFER LARA (CMT-MA)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LARA
Last Name:PACHT-GOODMAN
Suffix:
Gender:F
Credentials:CMT-MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 JOHNSTON DR
Mailing Address - Street 2:
Mailing Address - City:WATCHUNG
Mailing Address - State:NJ
Mailing Address - Zip Code:07069-6420
Mailing Address - Country:US
Mailing Address - Phone:917-922-3227
Mailing Address - Fax:
Practice Address - Street 1:1308 JOHNSTON DR
Practice Address - Street 2:
Practice Address - City:WATCHUNG
Practice Address - State:NJ
Practice Address - Zip Code:07069-6420
Practice Address - Country:US
Practice Address - Phone:917-922-3227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-20
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist