Individual
LISA P SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
210 EAST DERENNE AVE, SAVANNAH, GA 31405
(912) 644-5300
(912) 644-5260
Mailing address
210 EAST DERENNE AVE, SAVANNAH, GA 31405
(912) 644-5300
(912) 644-5260
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT002789
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT002789
STATE LISC NUMBER
GA
Enumeration date
11/16/2006
Last updated
05/10/2019
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