Individual
TRACI MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
3100 W LAKEWAY RD STE 1, GILLETTE, WY 82718-6373
(307) 622-1242
Mailing address
4719 FAIRFAX LOOP, BISMARCK, ND 58503-5827
(701) 391-2384
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
1480
WY
225X00000X
Occupational Therapist
Primary
935
ND
Other
Enumeration date
10/01/2007
Last updated
03/30/2020
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