Individual
JONATHAN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS OT
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Mailing address
10986 CRAFT ST, DETROIT, MI 48224-2434
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
26663
CA
225X00000X
Occupational Therapist
5201010064
MI
Other
Enumeration date
03/07/2018
Last updated
07/24/2025
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