Individual
MISS LEEANNA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
619 6TH ST W, PARK RAPIDS, MN 56470-1301
(218) 732-3329
Mailing address
626 34TH ST NW, BEMIDJI, MN 56601-2189
(740) 258-0400
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
202563
MN
Other
Enumeration date
11/25/2020
Last updated
11/25/2020
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