Individual
MARY ELLEN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.R
Contact information
Practice address
165 ERNEST RD, STANFORDVILLE, NY 12581-5907
(845) 868-7278
(845) 868-7278
Mailing address
165 ERNEST RD, STANFORDVILLE, NY 12581-5907
(845) 868-7278
(845) 868-7278
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
004089-1
NY
Other
Enumeration date
11/04/2008
Last updated
11/04/2008
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