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Individual

MAREN JANE SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT, DPT

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2412
SD
225100000X
Physical Therapist
Primary
4109
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2412
LICENSE
SD
01
4109
PHYSICAL THERAPY LICENSE
NE
Enumeration date
08/06/2020
Last updated
03/31/2026
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