# GOODWILL EASTER SEALS OF THE GULF COAST

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902007727
- **Authorized official:** SUSAN F SPRAGGINS (DIRECTOR CHILDREN'S SERVICES)
- **Authorized official phone:** (251) 471-1581

## Contact information

- **Practice address:** 2448 GORDON SMITH DR, MOBILE, AL 36617-2319
- **Practice address phone:** (251) 471-1581
- **Practice address fax:** (251) 476-4303
- **Mailing address:** 2448 GORDON SMITH DR, MOBILE, AL 36617-2319
- **Mailing address phone:** (251) 471-1581
- **Mailing address fax:** (251) 476-4303

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | Yes |
| 225X00000X | Occupational Therapist | — | — | Yes |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 05/30/2007
- **Last updated:** 09/11/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 529909360 | BILLING PAYEE NUMBER | AL |