Individual
MELINDA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
303 N HURSTBOURNE PKWY STE 200, LOUISVILLE, KY 40222-5158
(502) 412-5847
Mailing address
403 ECCHAPPE LN, FAIRDALE, KY 40118-9527
(502) 931-9379
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
276356
KY
Other
Enumeration date
10/26/2012
Last updated
10/26/2012
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