Provider Demographics
NPI:1548583628
Name:GODZDANKER, CARLA (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:GODZDANKER
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:CARLA
Other - Middle Name:
Other - Last Name:HEYMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1745 KINSMON CV
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-8173
Mailing Address - Country:US
Mailing Address - Phone:770-402-8934
Mailing Address - Fax:
Practice Address - Street 1:1745 KINSMON CV
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-8173
Practice Address - Country:US
Practice Address - Phone:770-402-8934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-03
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2881225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist