Provider Demographics
NPI:1538635156
Name:GOODSPEED, ANN M
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:GOODSPEED
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 1:32801 GLEN DR
Mailing Address - Street 2:
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-3401
Mailing Address - Country:US
Mailing Address - Phone:440-328-6704
Mailing Address - Fax:
Practice Address - Street 1:1531 W RIVER RD N
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-2700
Practice Address - Country:US
Practice Address - Phone:440-324-4788
Practice Address - Fax:440-324-4087
Is Sole Proprietor?:No
Enumeration Date:2018-10-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH11095237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist