Individual
SHANNON M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
6565 WEST MAIN SUITE 101, KALAMAZOO, MI 49009
(269) 372-1027
(269) 372-2940
Mailing address
6565 WEST MAIN SUITE 101, KALAMAZOO, MI 49009
(269) 372-1027
(269) 372-2940
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1040983
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1040983
COTA #
MI
Enumeration date
08/29/2006
Last updated
07/08/2007
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