Individual
MISS JENNY LEE GOEDL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1701 LIBRARY BLVD STE A, GREENWOOD, IN 46142-1567
(317) 881-9923
Mailing address
1053 CHULA VISTA CT, GREENWOOD, IN 46143-2242
(317) 698-9210
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
32002147A
IN
Other
Enumeration date
04/30/2012
Last updated
04/30/2012
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