Individual
KANDI RAE GOODREAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
191 N MAIN ST, WELLSVILLE, NY 14895-1150
(585) 596-4011
Mailing address
191 N MAIN ST, WELLSVILLE, NY 14895-1150
(585) 596-4011
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
009337
NY
Other
Enumeration date
10/18/2022
Last updated
10/18/2022
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