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NPI Code Detail

MEDICARE: CHELYNN NICOLE GODFREY OTA/L

MEDICARE: CHELYNN NICOLE GODFREY OTA/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant03522OH
2224Z00000XOccupational Therapy Assistant16186FL

General Provider Information

NPI Number : 1013114651
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHELYNN NICOLE GODFREY OTA/L
Provider Business Mailing Address
First Line : 543 PERIWINKLE DR
Second Line :
City : SEBASTIAN
State : FL
Zip : 32958-6527
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4150 INDIAN RIVER BLVD
Second Line :
City : VERO BEACH
State : FL
Zip : 32967-7224
Country : US
Telephone Number : 772-732-6316
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2007
Last Update Date : 03/28/2025

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