Provider Demographics
NPI:1194002238
Name:GOFF, CINDY R (MA,SLP-CCC)
Entity Type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:R
Last Name:GOFF
Suffix:
Gender:F
Credentials:MA,SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4181 W UPRIVER DR
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-7890
Mailing Address - Country:US
Mailing Address - Phone:208-305-9571
Mailing Address - Fax:
Practice Address - Street 1:4181 W UPRIVER DR
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-7890
Practice Address - Country:US
Practice Address - Phone:208-305-9571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-03
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDSLP-2042235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist