Individual
LESHAWN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
104A TANYARD AVENUE, GREENWOOD, SC 29646
(864) 321-9171
Mailing address
104A TANYARD AVENUE, GREENWOOD, SC 29646
(864) 321-9171
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
3130
SC
Other
Enumeration date
08/03/2015
Last updated
08/03/2015
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