Goodwine, Amy Nicole

Goodwine, Amy Nicole is an sole proprietor health care provider with primary practice located at 3986 Fettler Park Dr , Dumfries VA 22025-1997. She recently has 2 registered licenses in different health care specialties including Speech, Language and Hearing Service Providers / Audiologist, Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter. Speech, Language and Hearing Service Providers / Audiologist is her primary health care specialty. Goodwine, Amy Nicole can be contacted via phone (703) 221-8307.

Contact Information

Primary practice address
3986 Fettler Park Dr Dumfries VA 22025-1997
Phone: (703) 221-8307
Fax: (703) 221-8548
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist 231H00000X 2201000658 Virginia
Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter 237600000X 2101001172 Virginia

Profile Details

NPI number 1285698308
LBN Legal business name Goodwine, Amy Nicole
Credentials AU.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 14th, 2006
Last updated Nov 2nd, 2022 - about 2 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 1285698308 NPPES
Virginia MEDICAID 010244919
Virginia Other 392788YGFF

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