Individual
MICHELLE H SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2309 S SERVICE RD W, RUSTON, LA 71270-3167
(318) 232-1969
(318) 232-1970
Mailing address
PO BOX 1377, WEST MONROE, LA 71294-1377
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
334653
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
334653
STATE LICENSE
LA
Enumeration date
02/01/2023
Last updated
02/01/2023
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