Individual
MRS. KRISTINE ANN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
4902 S VAL VISTA DR, SUITE B102, GILBERT, AZ 85298-7325
(480) 855-8866
(480) 855-8867
Mailing address
2285 E APPLEBY RD, GILBERT, AZ 85298-9307
(602) 579-1917
(480) 659-2693
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0718
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0718
STATE LICENSE
AZ
05
—
133851
—
AZ
Enumeration date
03/27/2007
Last updated
08/19/2008
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