Individual
CHRISTINA MARIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
302 CEDAR RIDGE RD, SISSONVILLE, WV 25320-9502
(304) 984-0046
Mailing address
711 FERRELL RD APT 103, SAINT ALBANS, WV 25177-7473
(304) 807-1214
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C1771
WV
Other
Enumeration date
05/03/2011
Last updated
05/03/2011
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