Individual
BENITA GORDONSMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4103 MAID MARIAN CIR, KILLEEN, TX 76549-4515
(254) 634-1802
Mailing address
4103 MAID MARIAN CIR, KILLEEN, TX 76549-4515
(254) 634-1802
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
208497
TX
Other
Enumeration date
04/17/2007
Last updated
07/08/2007
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