NPI 1700540200

Kelly Amanda Goddard

Practitioner Athletic Trainer Stratford, CT

Practice location

Address: 201 Nichols Ter, Stratford, CT 06614-3959
Phone: (203) 377-1752

Registered specialties (2)

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 1851 (CT)

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Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1700540200
Entity type: Individual
Sex (as registered): Female
NPI issued: 29 Oct 2021
Record last updated: 2 Jun 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.