Sharon V Goen, BS SPEECH THERAPY

Individual provider Active NPI Speech-Language Pathologist · Moberly, MO

NPI 1659406262 · NPPES record last updated Feb 19, 2009

Key facts

NPI
1659406262
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
00076 (MO)
Practice address
Moberly Public School
926 Kwix Rd
Moberly, MO 65270-3813
Phone
(660) 269-2600
Fax
(660) 269-2611
NPI assigned
Feb 22, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
00076MOMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 00076 MO Yes

Addresses

Primary practice location

Moberly Public School
926 Kwix Rd
Moberly, MO 65270-3813

Mailing address

926 Kwix Rd
Moberly, MO 65270-3813
Phone (660) 269-2600

Other identifiers

IdentifierTypeStateIssuer
463648303MedicaidMO

Other providers in Moberly, MO

All providers in Moberly, MO · Speech-Language Pathologist in Missouri

Sources for this page

Verify at the official NPI Registry.