Individual
MS. JANE B SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
4432 MIKE LN, FORT WORTH, TX 76116-8111
(817) 735-1019
Mailing address
4432 MIKE LN, FORT WORTH, TX 76116-8111
(817) 735-1019
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
104697
TX
Other
Enumeration date
04/18/2007
Last updated
07/08/2007
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