Individual
MRS. THERESE GEORGETTE GOODCHILD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP, M.E.D
Contact information
Practice address
37 BRANTWOOD RD, WORCESTER, MA 01602-1705
(413) 695-6670
Mailing address
37 BRANTWOOD RD, WORCESTER, MA 01602-1705
(413) 695-6670
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0003655
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0003655
LICENSE #
MA
05
—
0304336
—
MA
Enumeration date
12/28/2010
Last updated
12/28/2010
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