Individual
BRENDA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2290 CROW CREEK RD, BETTENDORF, IA 52722-2096
(563) 332-0892
Mailing address
2290 CROW CREEK RD, BETTENDORF, IA 52722-2096
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
00343
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00343
STATE LISC NUMBER
IA
Enumeration date
12/31/2013
Last updated
12/31/2013
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