Individual
KELLIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4140 OLD WASHINGTON RD, WALDORF, MD 20602-3221
(301) 645-2813
Mailing address
4140 OLD WASHINGTON RD, WALDORF, MD 20602-3221
(301) 645-2813
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A02054
MD
Other
Enumeration date
12/08/2015
Last updated
12/08/2015
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