Individual
PAMELA LOUISE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
303 N HURSTBOURNE PKWY STE 200, LOUISVILLE, KY 40222-5158
(502) 412-5847
Mailing address
1513 DOUGLAS LN, CRETE, IL 60417-3210
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.002255
IL
Other
Enumeration date
11/24/2014
Last updated
11/24/2014
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