Individual
WENDY E GODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
15834 CLAYTON RD, ELLISVILLE, MO 63011-2212
(636) 227-2339
(636) 227-8711
Mailing address
15834 CLAYTON RD, ELLISVILLE, MO 63011-2212
(636) 227-2339
(636) 227-8711
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2009008909
MO
225XP0200X
Pediatric Occupational Therapist
2009008909
MO
Other
Enumeration date
06/09/2009
Last updated
06/09/2009
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