Jody Goldsborough, MA, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Rydal, PA
NPI 1487779146 · NPPES record last updated Jun 8, 2009
Key facts
- NPI
- 1487779146
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SL00001479L (PA)
- Practice address
- 756 Suffolk Rd
Rydal, PA 19046-3426 - Phone
- (215) 885-7103
- NPI assigned
- Mar 20, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SL00001479L | PA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SL00001479L | PA | Yes |
Addresses
Primary practice location
756 Suffolk Rd
Rydal, PA 19046-3426
Mailing address
756 Suffolk Rd
Rydal, PA 19046-3426
Phone (215) 885-7103
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All providers in Rydal, PA · Speech-Language Pathologist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.