Individual
KELLEY SUE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L, ATP
Contact information
Practice address
24 HIGHLAND AVE, NEWPORT, ME 04953-3229
(207) 321-1015
Mailing address
24 HIGHLAND AVE, NEWPORT, ME 04953-3229
(207) 321-1015
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OA622
ME
Other
Enumeration date
12/20/2017
Last updated
12/20/2017
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