Individual
KASSANDRA LYNN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
729 W 35TH ST, MARION, IN 46953-4215
(765) 674-9050
Mailing address
1418 TULIP TREE RD, FORT WAYNE, IN 46825-4848
(260) 484-8144
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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