Individual
LACY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11660 ALPHARETTA HWY STE 200, ROSWELL, GA 30076-3874
(404) 436-7416
Mailing address
11660 ALPHARETTA HWY STE 200, ROSWELL, GA 30076-3874
(404) 436-7416
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA003116
GA
Other
Enumeration date
05/05/2025
Last updated
05/05/2025
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