Individual
TONI SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3110 191ST PL, LANSING, IL 60438-3716
(407) 961-6363
Mailing address
3110 191ST PL, LANSING, IL 60438-3716
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057004534
IL
Other
Enumeration date
12/22/2016
Last updated
12/22/2016
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