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Individual

MS. KIA MICHELLE SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MOTR/L, MPH

Contact information

Practice address
14601 JOHN HUMPHREY DRIVE, ORLAND PARK, IL 60462
(708) 349-8300
(708) 403-7608
Mailing address
14601 JOHN HUMPHREY DR, ORLAND PARK, IL 60462-2641
(708) 349-8300
(708) 403-7608

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.10007
IL

Other

Enumeration date
07/31/2013
Last updated
07/31/2013
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