Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mia Goodly

Individual provider Occupational Therapy Assistant · NPI 1639623499

Mia Goodly is an Occupational Therapy Assistant in Port Orange, Florida. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2016

Practice location Address checks out

5535 S Williamson Blvd Ste 774
Port Orange, FL 32128-8311
Phone: (888) 265-2680
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence 057004116 (IL)

Record details

NPI number1639623499
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 10, 2016
Last updated in NPPESAugust 10, 2016
Mailing address5535 S Williamson Blvd, Suite 774, Port Orange, FL 32128-8311

Other providers in Port Orange