Provider Demographics
NPI:1689240533
Name:GOODLIN, ANGELA E
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:E
Last Name:GOODLIN
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 1:5325 NATORP BLVD RM 216
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-7996
Mailing Address - Country:US
Mailing Address - Phone:214-673-4008
Mailing Address - Fax:
Practice Address - Street 1:5325 NATORP BLVD RM 216
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-7996
Practice Address - Country:US
Practice Address - Phone:214-673-4008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic