| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JACQUELINE MARIE GODWIN | 1013590629 | 2021-04-30 |
Jacqueline Marie Godwin is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1013590629. Registration indicates Jacqueline Marie Godwin is a provider of services with a specialization in Respiratory, Developmental, Rehabilitative and Restorative Service Providers, Occupational Therapy Assistant (Occupational Therapy Assistant, ) (Speech/Occupational/Physical Therapy/Chiropractor, ) (Occupational Therapy Assistant, Respiratory, Developmental, Rehabilitative and Restorative Service Providers)
| Entity Type | Individual |
| Provider Name | Jacqueline Marie Godwin COTA/L |
| Practice Office Address | 1507 S TUTTLE AVE SARASOTA, FL US |
| Practice Office Telephone | 9413660336 |
| Mailing Address | 16467 LITTLE GARDEN DR WIMAUMA, FL 335982405 US |
| Business Telephone | 8136529033 |
| Code | Practice | License No State |
|---|---|---|
| 224Z00000X PRIMARY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Occupational Therapy Assistant Occupational Therapy Assistant Speech/Occupational/Physical Therapy/Chiropractor Occupational Therapy Assistant Respiratory, Developmental, Rehabilitative and Restorative Service Providers | 17870
FL |