Provider Demographics
NPI:1639573108
Name:GOODHUE, CHRISTINE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:GOODHUE
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:KWONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:298 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-4145
Mailing Address - Country:US
Mailing Address - Phone:603-352-7311
Mailing Address - Fax:
Practice Address - Street 1:298 MAIN ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-4145
Practice Address - Country:US
Practice Address - Phone:603-352-7311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-13
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1619235Z00000X
NHP-0602235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist