Individual
NIKI SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
90A CLARK BLVD, TUPELO, MS 38804-2801
(662) 840-0535
Mailing address
191 HIGHWAY 45, RIENZI, MS 38865-9542
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT1363
MS
Other
Enumeration date
01/30/2015
Last updated
01/30/2015
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