Ms. Crystal Ann Goodrich
Occupational Therapist
17 Highland Ave
South Portland
, Maine 04106-3726
Ms. Crystal Ann Goodrich
Occupational Therapist
17 Highland Ave
South Portland
, Maine 04106-3726
(207) 671-6939
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About
Features
Specialties
- Occupational Therapist
Languages spoken
- English
Location
First Address
- Ms. Crystal Ann Goodrich
- 17 Highland Ave
- South Portland, ME
- Zip : 04106-3726
- Phone : (207) 671-6939
Second Address
- Ms. Crystal Ann Goodrich
- 17 Highland Ave
- South Portland, ME
- Zip : 04106-3726
- Phone : (207) 671-6939
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225X00000X | Occupational Therapist | OT1010 | ME |
National Provider Identifier
| NPI | 1003028994 |
|---|---|
| Provider Name | Ms. Crystal Ann Goodrich |
| First Address | South Portland, ME 04106-3726 |
| Second Address | South Portland, ME 04106-3726 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/05/2007 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 061453 | ANTEM ID # (01) | ME |
| 11364530 | CAQH (01) | ME |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.