Individual
ANGIE GODCHAUX-KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
3400 MONTGOMERY DR, SANTA ROSA, CA 95405-5142
(707) 526-6902
Mailing address
3400 MONTGOMERY DR, SANTA ROSA, CA 95405-5142
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
CA
Other
Enumeration date
10/23/2025
Last updated
11/11/2025
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