Individual
BRENDA RAE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
844 N ELLSWORTH RD, MESA, AZ 85207-5114
(480) 380-2810
(480) 380-2861
Mailing address
844 N ELLSWORTH RD, MESA, AZ 85207-5114
(480) 380-2810
(480) 380-2861
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5512
AZ
Other
Enumeration date
08/15/2013
Last updated
08/15/2013
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