Kelly Amanda Goddard
Specialist/Technologist, Athletic Trainer in Stratford, CT. Individual provider (NPI-1).
NPI number1700540200
StatusActive
Last updated in NPPESJun 2, 2024
Details
- NPI
- 1700540200
- Entity type
- Individual (NPI-1)
- Name
- Kelly Amanda Goddard
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 29, 2021
- Certification date
- Jun 2, 2024
- Last updated
- Jun 2, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 1851 | CT | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | CT |
Practice location
201 Nichols TerStratford, CT 06614-3959
Phone 203-377-1752
Mailing address
201 Nichols TerStratford, CT 06614-3959
Phone 203-377-1752
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Athletic Trainer providers in Stratford, CT
- Ashley Frisina-Deyo, MS, ATC, LATNPI 1730631979
- Michael Harry Groves, ATC, LATNPI 1033651617
- Dana Lynn Jusino, ATCNPI 1891963146
- Daniel Joseph LeeNPI 1396551198
- Daniel PerilloNPI 1669976544
- Julliana TapiaNPI 1477061158
- Shannon Elizabeth TripodiNPI 1659912194
All 8 Athletic Trainer providers in Stratford · All 961 providers in Stratford
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.