Individual
SIDNYE BLAKE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
900 JUNCTION DR, ALLEN, TX 75013-5290
(469) 675-3153
Mailing address
3400 HOWELL ST APT 401, DALLAS, TX 75204-3548
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
122137
TX
Other
Enumeration date
07/12/2022
Last updated
07/12/2022
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