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Individual

SHAWANA D SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
2496 WEST 28TH ST, JACKSONVILLE, FL 32209-3220
(904) 861-7434
Mailing address
2496 W 28TH ST, JACKSONVILLE, FL 32209-3553
(904) 861-7434

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
16892
FL

Other

Enumeration date
11/14/2018
Last updated
11/14/2018
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