Individual
KELSEY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2689
(313) 916-2600
Mailing address
2114 BAUMEY ST, WYANDOTTE, MI 48192-3034
(313) 378-9501
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202008371
MI
Other
Enumeration date
03/23/2021
Last updated
03/30/2021
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