Individual
MS. MARY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
6979 TEAYS VALLEY RD, SCOTT DEPOT, WV 25560-7097
(681) 235-7156
Mailing address
PO BOX 977, HURRICANE, WV 25526-0977
(681) 235-7156
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2539
WV
225X00000X
Occupational Therapist
4172
MS
Other
Enumeration date
08/02/2024
Last updated
03/27/2025
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