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Individual

MS. SUSAN LYNN SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
C.O.T.A.

Contact information

Practice address
316 N MILWAUKEE ST, SUITE 208, MILWAUKEE, WI 53202-5885
(414) 264-5690
Mailing address
316 N MILWAUKEE ST, SUITE 208, MILWAUKEE, WI 53202-5885
(414) 264-5690

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1051-27
WI

Other

Enumeration date
04/30/2010
Last updated
04/30/2010
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