Individual
HEATHER SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5 N CREST PL, LAKEWOOD, NJ 08701-2967
(215) 888-6484
Mailing address
828 S 48TH ST, PHILA, PA 19143-3525
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC005744L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010831630002
—
PA
Enumeration date
05/09/2008
Last updated
05/09/2008
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