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NPI 1386857431

NPI 1386857431 : PAT GOODRICH SLP : LITCHFIELD PARK, AZ

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General NPI Number Information
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    NPI Number           |    1386857431
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    Entity Type          |    Individual 
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    Provider Name        |    PAT GOODRICH SLP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/07/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    553 E PLAZA CIR 
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    City                 |    LITCHFIELD PARK
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    State                |    AZ
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    Zip                  |    85340-4930
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    Country              |    US
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    Telephone            |    623-535-6000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4702 N GREENVIEW CIR W 
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    City                 |    LITCHFIELD PARK
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    State                |    AZ
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    Zip                  |    85340-5010
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    Country              |    US
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    Telephone            |    623-935-1449
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    235Z00000X
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    Taxonomy Name        |    Speech-Language Pathologist
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    License Number       |    SLPL1437
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    License Number State |    AZ
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