Individual
STEFANIE M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1037 28TH ST S, LA CROSSE, WI 54601-6041
(608) 397-3046
Mailing address
1037 28TH ST S, LA CROSSE, WI 54601-6041
(608) 397-3046
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4713-27
WI
Other
Enumeration date
10/18/2012
Last updated
10/18/2012
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