Goodreau, Mackenzie M.

Goodreau, Mackenzie M. is an individual health care provider with primary practice located at 128 E Olin Ave , Madison WI 53713-1467. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Goodreau, Mackenzie M. can be contacted via phone (608) 252-1320.

Contact Information

Primary practice address
128 E Olin Ave Madison WI 53713-1467
Fax: (608) 252-1333
Website:

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 5234 Wisconsin

Profile Details

NPI number 1902476435
LBN Legal business name Goodreau, Mackenzie M.
Credentials CCC-SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 2021
Last updated Jun 28th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902476435 NPPES
Wisconsin Other 5234-154 WI DEPARTMENT OF SAFETY & PROFESSIONAL SERVICES

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