Provider Demographics
NPI:1700133816
Name:GOOTEE, MARY HELEN (H I S)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:HELEN
Last Name:GOOTEE
Suffix:
Gender:F
Credentials:H I S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10443 N COUNTY ROAD 1000 E
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-9679
Mailing Address - Country:US
Mailing Address - Phone:317-697-3388
Mailing Address - Fax:317-769-3212
Practice Address - Street 1:10443 N COUNTY ROAD 1000 E
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-9679
Practice Address - Country:US
Practice Address - Phone:317-697-3388
Practice Address - Fax:317-769-3212
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN17001327A237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist