Individual
CAITLIN SMEDEMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1701 S CREASY LN, LAFAYETTE, IN 47905-4972
(000) 000-0000
Mailing address
3950 AUSTELL RD, AUSTELL, GA 30106-1121
(000) 000-0000
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31006148A
IN
225X00000X
Occupational Therapist
4197
TN
225X00000X
Occupational Therapist
OT2407
MS
Other
Enumeration date
02/07/2011
Last updated
11/06/2020
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