Individual
MARESA EVANE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1551 JENNINGS MILL RD UNIT 1700A, BOGART, GA 30622-2566
(706) 369-9099
Mailing address
3603 WHITLOW RIDGE DR, BISHOP, GA 30621-6519
(404) 783-6090
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
5599
NC
225X00000X
Occupational Therapist
Primary
OT004632
GA
Other
Enumeration date
08/08/2006
Last updated
03/11/2008
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