Individual
KIMBERLY DEARING-GOODFELLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
803 S MAIN ST, WOODSTOCK, VA 22664-1125
(352) 422-3422
Mailing address
803 S MAIN ST, WOODSTOCK, VA 22664-1125
(352) 422-3422
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
0131001361
VA
224Z00000X
Occupational Therapy Assistant
Primary
OTA7658
FL
Other
Enumeration date
09/30/2014
Last updated
11/05/2014
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