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Individual

MRS. SHERETTA L GAMBLE-SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
409 E 10TH ST, ANNISTON, AL 36207-4780
(256) 238-0110
(256) 238-5143
Mailing address
1690 SHELBY DR, SOUTHSIDE, AL 35907-0628
(256) 547-1387

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1650
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1650
OT LICENSE
AL
Enumeration date
12/15/2006
Last updated
07/08/2007
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