Individual
JUDITH A SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
4106 OGLETOWN STANTON RD, NEWARK, DE 19713-4169
(302) 894-1600
(302) 894-1601
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
U10001044
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295904357
CHAMPUS TRICARE
—
05
—
1295904357
—
DE
01
—
3506369000
IBC
—
Enumeration date
02/22/2008
Last updated
03/15/2013
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