Provider Demographics
NPI:1225310543
Name:GODEK, JANICE H (OTA/L)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:H
Last Name:GODEK
Suffix:
Gender:F
Credentials:OTA/L
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:H
Other - Last Name:FELKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:85 GIANT OAK DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28716-9424
Mailing Address - Country:US
Mailing Address - Phone:407-579-5698
Mailing Address - Fax:
Practice Address - Street 1:25 REYNOLDS MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-1270
Practice Address - Country:US
Practice Address - Phone:828-484-8660
Practice Address - Fax:828-484-8661
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2015-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8092224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant