Individual
MRS. MARY JACKSON SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
13700 N GAYTON RD, RICHMOND, VA 23233-7017
(804) 364-6352
Mailing address
8315 FORGE RD, RICHMOND, VA 23228-3127
(804) 266-8939
(804) 266-8939
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119000372
VA
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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