Individual
MRS. BETHANY GOODRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2185 NORMANDIE DR, MONTGOMERY, AL 36111-2728
(334) 288-0240
Mailing address
2185 NORMANDIE DR, MONTGOMERY, AL 36111-2728
(334) 288-0240
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5123
AL
Other
Enumeration date
09/16/2020
Last updated
09/16/2020
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