Provider Demographics
NPI:1275030330
Name:GOODIE, CYNTHIA YVETTE
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:YVETTE
Last Name:GOODIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3104 APPLE BLOSSOM LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2614
Mailing Address - Country:US
Mailing Address - Phone:469-471-8604
Mailing Address - Fax:
Practice Address - Street 1:3104 APPLE BLOSSOM LN
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2614
Practice Address - Country:US
Practice Address - Phone:469-471-8604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-06
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management