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Individual

MRS. AMANDA ELIZABETH SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, OTRL

Contact information

Practice address
18501 ROTUNDA DR STE 100, DEARBORN, MI 48124-3891
(313) 996-1949
Mailing address
18501 ROTUNDA DR STE 100, DEARBORN, MI 48124-3891
(313) 996-1930
(313) 996-1935

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201008628
MI
225XP0200X
Pediatric Occupational Therapist
5201008628
MI

Other

Enumeration date
10/18/2013
Last updated
09/12/2018
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