Individual
LISA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10300 W 103RD ST, SUITE 300, OVERLAND PARK, KS 66214-2642
(913) 894-1910
Mailing address
10300 W 103RD ST, SUITE 300, OVERLAND PARK, KS 66214-2642
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
17-01969
KS
225X00000X
Occupational Therapist
2001017570
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17-01969
STATE LICENSE
KS
01
—
2001017570
STATE LISENCE
MO
Enumeration date
05/24/2007
Last updated
07/08/2007
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