Individual
KEAGAN NICOLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
424 SARALAND BLVD N STE F, SARALAND, AL 36571-2153
(251) 455-4871
Mailing address
8964 RAND AVE APT 4208, DAPHNE, AL 36526-9157
(251) 455-4871
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
21211
FL
225X00000X
Occupational Therapist
Primary
5371
AL
Other
Enumeration date
10/30/2020
Last updated
10/30/2020
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