Mia Goodly

Occupational Therapy Assistant · Port Orange, FL

Individual Active NPI

NPI number 1639623499

Practice location

5535 S Williamson Blvd
Suite 774
Port Orange, FL 32128-8311
Phone
(888) 265-2680

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NPI record

NPI
1639623499
Entity type
Individual (Type 1)
Enumeration date
August 10, 2016
Last updated
August 10, 2016
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Occupational Therapy Assistant Primary 224Z00000X 057004116 IL

About Mia Goodly

Mia Goodly is a healthcare provider registered in the NPI registry with the primary taxonomy Occupational Therapy Assistant (code 224Z00000X). The practice location is 5535 S Williamson Blvd, Suite 774, Port Orange, FL 32128-8311. The NPI number 1639623499 was assigned on August 10, 2016 and the record was last updated on August 10, 2016.

Mia Goodly lists a license in the registry: #057004116 (IL) for Occupational Therapy Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Mia Goodly?

The NPI number is 1639623499.

What is the phone number of Mia Goodly?

The phone number listed for the practice location is (888) 265-2680.

Where is Mia Goodly located?

5535 S Williamson Blvd, Suite 774, Port Orange, FL 32128-8311.

What is the taxonomy code for Mia Goodly?

The primary taxonomy code is 224Z00000X – Occupational Therapy Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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