Provider Demographics
NPI:1558753459
Name:GOOD, CRISTIE (SLP)
Entity Type:Individual
Prefix:
First Name:CRISTIE
Middle Name:
Last Name:GOOD
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 OLD TIMBER TRL
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-2113
Mailing Address - Country:US
Mailing Address - Phone:412-251-6576
Mailing Address - Fax:
Practice Address - Street 1:21 OLD TIMBER TRL
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-2113
Practice Address - Country:US
Practice Address - Phone:412-251-6576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL011762235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist