Provider Demographics
NPI:1851278907
Name:MCGOOGAN, ENJOULI R
Entity type:Individual
Prefix:
First Name:ENJOULI
Middle Name:R
Last Name:MCGOOGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4543 PEN LUCY RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-2842
Mailing Address - Country:US
Mailing Address - Phone:571-830-4943
Mailing Address - Fax:
Practice Address - Street 1:4543 PEN LUCY RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-2842
Practice Address - Country:US
Practice Address - Phone:571-830-4943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor