Individual
TRACEY LEE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4603 TIMBERWALK CT, LA GRANGE, KY 40031-6746
(703) 864-6695
Mailing address
4603 TIMBERWALK CT, LA GRANGE, KY 40031-6746
(703) 864-6695
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
136195
KY
Other
Enumeration date
10/31/2016
Last updated
04/09/2020
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