Provider Demographics
NPI:1821654955
Name:GOYDICH, ANGEL (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:
Last Name:GOYDICH
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 BOONE RD
Mailing Address - Street 2:
Mailing Address - City:TRAFFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15085-2331
Mailing Address - Country:US
Mailing Address - Phone:724-217-0731
Mailing Address - Fax:
Practice Address - Street 1:209 BOONE RD
Practice Address - Street 2:
Practice Address - City:TRAFFORD
Practice Address - State:PA
Practice Address - Zip Code:15085-2331
Practice Address - Country:US
Practice Address - Phone:724-217-0731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-14
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL012150235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist