Individual
MRS. AMANDA MARIE SMITHSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2001 HOBSON RD, FORT WAYNE, IN 46805-4872
(260) 484-9557
Mailing address
629 LILLIAN AVE, FORT WAYNE, IN 46808-2111
(260) 483-2217
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001232A
IN
Other
Enumeration date
01/21/2010
Last updated
01/21/2010
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