Provider Demographics
NPI:1891161261
Name:KINSLEY, DANIELLE GODDARD (OTR/L, CCLS)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:GODDARD
Last Name:KINSLEY
Suffix:
Gender:F
Credentials:OTR/L, CCLS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 DAVIS RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-5400
Mailing Address - Country:US
Mailing Address - Phone:912-667-6006
Mailing Address - Fax:
Practice Address - Street 1:945 DAVIS RD
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-5400
Practice Address - Country:US
Practice Address - Phone:912-667-6006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-19
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT007134225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist