Individual
BARBARA M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
835 S VAN BUREN ST, GREEN BAY, WI 54301-3526
(920) 433-0111
(920) 433-8765
Mailing address
PO BOX 13508, GREEN BAY, WI 54307-3508
(920) 433-0111
(920) 433-8765
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
782
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40786600
—
WI
Enumeration date
09/14/2007
Last updated
09/18/2012
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