Individual
MS. TAMARA DONETTE GODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
645 SCUFFLETOWN RD, SIMPSONVILLE, SC 29681-4235
(678) 472-8144
Mailing address
307 FAIRVIEW STREET EXT, FOUNTAIN INN, SC 29644-9059
(678) 472-8144
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA2334
SC
Other
Enumeration date
10/11/2021
Last updated
10/11/2021
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