Individual
MRS. GRACELYN J. GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2711 CAPITAL MEDICAL BLVD, TALLAHASSEE, FL 32308-4497
(850) 210-1172
Mailing address
7820 HIGHWAY 90, SNEADS, FL 32460-2232
(850) 557-8686
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA17498
FL
Other
Enumeration date
09/09/2020
Last updated
09/09/2020
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