Basic Information
| Provider Information | |||||||||
| NPI: | 1619219813 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOODMAN | ||||||||
| FirstName: | BARBARA | ||||||||
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| Credential: | SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1255 CALDWELL RD | ||||||||
| Address2: | |||||||||
| City: | CHERRY HILL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080343220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563481209 | ||||||||
| FaxNumber: | 8564294755 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 EAST KINGS HIGHWAY | ||||||||
| Address2: | 2ND FLOOR SUITE 205 | ||||||||
| City: | CHERRY HILL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08034 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563481170 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2013 | ||||||||
| LastUpdateDate: | 09/08/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 41YS00655100 | NJ | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.