Provider Demographics
NPI:1477910438
Name:GOOD, ERIN
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:GOOD
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 1:104 ECHO RDG
Mailing Address - Street 2:
Mailing Address - City:BUCKNER
Mailing Address - State:MO
Mailing Address - Zip Code:64016-9705
Mailing Address - Country:US
Mailing Address - Phone:816-536-5442
Mailing Address - Fax:
Practice Address - Street 1:2706 NE INDEPENDENCE AVE
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-2323
Practice Address - Country:US
Practice Address - Phone:816-446-9018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-21
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015044729235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist