Individual
DEBRA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
501 N LAKE ST, PESHTIGO, WI 54157-1013
(715) 582-3906
(715) 582-3141
Mailing address
261 FRENCH ST, PESHTIGO, WI 54157-1217
(715) 582-2200
(715) 582-2222
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1767-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40721600
—
WI
Enumeration date
05/14/2008
Last updated
05/14/2008
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