Provider Demographics
NPI:1700195237
Name:GOUDY, MEIJIE CHEN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MEIJIE
Middle Name:CHEN
Last Name:GOUDY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:MEIJIE
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2480 HIGHWAY 100 S
Mailing Address - Street 2:APT. 232
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1762
Mailing Address - Country:US
Mailing Address - Phone:952-240-0223
Mailing Address - Fax:
Practice Address - Street 1:8320 CITY CENTRE DR
Practice Address - Street 2:SUITE G
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-3382
Practice Address - Country:US
Practice Address - Phone:651-738-9888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-01
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8561235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist