Individual
ERICA L GODIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22 TOMPKINS ST, WATERBURY, CT 06708-1459
(203) 419-0381
(203) 419-0389
Mailing address
33 MEDWAY RD, WATERBURY, CT 06708-3220
(203) 808-1966
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1209
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004190328
—
CT
Enumeration date
06/15/2011
Last updated
06/15/2011
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