Individual
MARIAH ROSE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
510 1ST ST, SPOONER, WI 54801-1241
(715) 635-1415
Mailing address
23690 BASHAW TRL, SHELL LAKE, WI 54871-9141
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
8825-26
WI
Other
Enumeration date
02/16/2026
Last updated
02/16/2026
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