Individual
JESSIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
40 N HURRICANE HLS, BOSTON, KY 40107-7500
(502) 827-4890
Mailing address
40 N HURRICANE HLS, BOSTON, KY 40107-7500
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
365375
OR
Other
Enumeration date
10/25/2016
Last updated
10/25/2016
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