Individual
HEATHER M SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
725 VICKIE DR, AZLE, TX 76020-2349
(817) 807-1212
Mailing address
725 VICKIE DR, AZLE, TX 76020-2349
(817) 807-1212
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
209542
TX
Other
Enumeration date
04/16/2012
Last updated
04/16/2012
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