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Individual
MISS TAYLOR SHEA SMITH
Active
Individual
MISS TAYLOR SHEA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
021148
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00314998
—
NY
01
—
14-1338413
TAX IDENTIFICATION
NY
Enumeration date
01/04/2017
Last updated
02/02/2017
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