Provider Demographics
NPI:1912027319
Name:GOLDOWSKY, MARCI L (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MARCI
Middle Name:L
Last Name:GOLDOWSKY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 LEXINGTON ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-3642
Mailing Address - Country:US
Mailing Address - Phone:781-575-0203
Mailing Address - Fax:781-575-0203
Practice Address - Street 1:16 LEXINGTON ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-3642
Practice Address - Country:US
Practice Address - Phone:781-575-0203
Practice Address - Fax:781-575-0203
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4671235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist