Individual
KATI SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 PARK LN W, CLINTON, IL 61727-2637
(217) 935-8500
Mailing address
4560 SE INTERNATIONAL WAY STE 100, MILWAUKIE, OR 97222-4628
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057003934
IL
Other
Enumeration date
06/08/2017
Last updated
06/08/2017
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