Provider Demographics
NPI:1467878033
Name:CRITERION
Entity Type:Organization
Organization Name:CRITERION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PER DIEM PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:GOODHILE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:978-632-4432
Mailing Address - Street 1:31 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440-3879
Mailing Address - Country:US
Mailing Address - Phone:978-632-4432
Mailing Address - Fax:197-863-2602
Practice Address - Street 1:31 LAKE ST
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440-3879
Practice Address - Country:US
Practice Address - Phone:978-632-4432
Practice Address - Fax:197-863-2602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-06
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5211252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency