Individual
DORIS M SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
11 FORREL TREE CT, SAINT PETERS, MO 63376-4612
(314) 412-1584
Mailing address
11 FORREL TREE CT, SAINT PETERS, MO 63376-4612
(314) 412-1584
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1999139234
MO
Other
Enumeration date
07/10/2007
Last updated
07/10/2007
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