Provider Demographics
NPI:1811622335
Name:GOODRUM, CYDNEY
Entity Type:Individual
Prefix:
First Name:CYDNEY
Middle Name:
Last Name:GOODRUM
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 1:8181 S COOLIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-5248
Mailing Address - Country:US
Mailing Address - Phone:719-440-8966
Mailing Address - Fax:
Practice Address - Street 1:8181 S COOLIDGE WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-5248
Practice Address - Country:US
Practice Address - Phone:719-440-8966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist