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NPI Lookup from the NPI Registry — National Provider Identifier Database

Contact Information

CRYSTAL A GOODRICH, MS, OTRL
17 HIGHLAND AVE
SOUTH PORTLAND, ME04106-3726
 Phone: 207-671-6939
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Therapist

225X00000X 67 Occupational Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for CRYSTAL A GOODRICH · (Female)

NPI Number 1003028994
Status Active
Credentials MS, OTRL
Entity Individual
Enumeration date 05/04/2007
Last updated 07/08/2007 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • ME License # OT1010
  • ME Other 061453 ANTEM ID #
  • ME Other 11364530 CAQH
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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