Individual
KENSEY ALENE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
113 COMMONS WAY STE 402, VILLA RICA, GA 30180-7040
(770) 459-6533
(770) 462-1260
Mailing address
2001 CHURCH LN, VILLA RICA, GA 30180-4720
(770) 459-6533
(770) 462-1260
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
315693
GA
Other
Enumeration date
01/04/2018
Last updated
01/04/2018
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