Individual
LISA SMALLWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1505 MADRONA ST N, TWIN FALLS, ID 83301-8318
(719) 659-1426
Mailing address
132 FILLMORE ST, TWIN FALLS, ID 83301-5206
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTP-OT-LIC-3996
MT
Other
Enumeration date
01/25/2016
Last updated
02/16/2024
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