Individual
MRS. KELLY B. GODFREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5110 S YALE AVE, STE 103, TULSA, OK 74135-7401
(918) 492-2386
(918) 645-8686
Mailing address
5110 S YALE AVE, STE 103, TULSA, OK 74135-7401
(918) 492-2386
(918) 645-8686
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
1464
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200085750A
—
OK
Enumeration date
08/31/2006
Last updated
09/04/2012
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