Individual
MACKENZIE ROSE GODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1135 OLDE W CHOCOLATE AVE, HUMMELSTOWN, PA 17036-9188
(717) 832-2600
Mailing address
9 N CAVESSON DR, GALLOWAY, NJ 08205-9665
(609) 335-3534
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC017046
PA
Other
Enumeration date
12/11/2020
Last updated
12/11/2020
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