Individual
SHEREE GOODALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1475 LYLE THOMAS RD, CONCORD, VA 24538-3261
(434) 993-3963
(434) 993-3556
Mailing address
PO BOX 106, CONCORD, VA 24538-0106
(434) 993-3963
(434) 993-3556
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000424
VA
Other
Enumeration date
03/18/2013
Last updated
03/18/2013
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