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Individual

MRS. KELLY D SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
801 NW SAINT MARY DR, STE 220, BLUE SPRINGS, MO 64014-2524
(816) 220-3900
(816) 220-0877
Mailing address
801 NW SAINT MARY DR, STE 220, BLUE SPRINGS, MO 64014-2524
(816) 220-3900
(816) 220-0877

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
005135
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
26739012
BCBS KC
MO
05
578907909
MO
Enumeration date
08/05/2006
Last updated
07/08/2007
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