Provider Demographics
NPI:1770831059
Name:GOODRICH, LINDSEY ANN
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ANN
Last Name:GOODRICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:ANN
Other - Last Name:SANBORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 DAVIS POINT LN
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:CAPE ELIZABETH
Mailing Address - State:ME
Mailing Address - Zip Code:04107-2620
Mailing Address - Country:US
Mailing Address - Phone:207-767-9773
Mailing Address - Fax:
Practice Address - Street 1:2 DAVIS POINT LN
Practice Address - Street 2:SUITE 1A
Practice Address - City:CAPE ELIZABETH
Practice Address - State:ME
Practice Address - Zip Code:04107-2620
Practice Address - Country:US
Practice Address - Phone:207-767-9773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-17
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP2102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist