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Individual

MRS. SHARRON BUSH SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.O.T.R.

Contact information

Practice address
102 RAPHAEL DR, LAFAYETTE, LA 70508-5952
(337) 849-7431
Mailing address
102 RAPHAEL DR, LAFAYETTE, LA 70508-5952
(337) 849-7431

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTT.Z10814
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1306843
LA
Enumeration date
05/07/2007
Last updated
12/08/2019
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