Individual
MRS. CHRISTINE MARIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
812 AIRPORT RD, GODFREY, IL 62035-2920
(618) 466-0756
Mailing address
812 AIRPORT RD, GODFREY, IL 62035-2920
(618) 466-0756
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.002063
IL
Other
Enumeration date
11/18/2021
Last updated
11/18/2021
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