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NPI Code Detail

MEDICARE: JILL C GOODHEART MA, CCC-SLP

MEDICARE: JILL C GOODHEART MA, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist2969KS

General Provider Information

NPI Number : 1619296365
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILL C GOODHEART MA, CCC-SLP
Provider Business Mailing Address
First Line : 4911 STATE AVE
Second Line :
City : KANSAS CITY
State : KS
Zip : 66102-1749
Country : US
Telephone Number : 913-287-8851
Fax Number : 913-287-5431
Provider Business Practice Location Address
First Line : 4911 STATE AVE
Second Line :
City : KANSAS CITY
State : KS
Zip : 66102-1749
Country : US
Telephone Number : 913-287-8851
Fax Number : 913-287-5431
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2010
Last Update Date : 05/20/2010

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Directions to “ JILL C GOODHEART MA, CCC-SLP” Practice Location

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