Individual
KALYRA ANANDA S GOODRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3480 RAVENCREEK LN, OVIEDO, FL 32766-7043
(407) 810-2225
Mailing address
40 GRAND AVE, MANITOU SPRINGS, CO 80829-1726
(805) 453-7743
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT11677
FL
225XP0200X
Pediatric Occupational Therapist
Primary
OT.0004466
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
812089700
—
FL
05
—
890148100
—
FL
Enumeration date
01/01/2007
Last updated
02/24/2016
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