Individual
DAYNA MICHELLE GODFREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4060 BASSEN DR, SWANSEA, IL 62226-7906
(618) 972-4810
Mailing address
4060 BASSEN DR, SWANSEA, IL 62226-7906
(618) 972-4810
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056011202
IL
225X00000X
Occupational Therapist
201519499
MO
Other
Enumeration date
10/13/2019
Last updated
10/13/2019
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