Individual
MR. KENYATT MOTTI GODBOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., CCC-SLP
Contact information
Practice address
3007 SIMMON TREE RD, CHARLOTTE, NC 28270-0676
(516) 521-2955
Mailing address
17020 130TH AVE, APT. 9D, JAMAICA, NY 11434-3283
(516) 521-2955
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
019089
NY
235Z00000X
Speech-Language Pathologist
Primary
8524
NC
Other
Enumeration date
06/02/2009
Last updated
06/02/2009
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