Individual
JAMIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
106 MOUNT VISTA RD, DENTON, NC 27239-8793
(336) 859-0773
Mailing address
4605 HIGH PINE CHURCH RD, ASHEBORO, NC 27205-9367
(336) 963-7708
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4709
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4709
NCBOT
NC
Enumeration date
04/15/2015
Last updated
04/15/2015
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