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Individual

SHANNON SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4121 SHELBYVILLE RD STE 7, LOUISVILLE, KY 40207-3205
(502) 893-1380
(502) 893-1773
Mailing address
90 HOWARD DR, SHELBYVILLE, KY 40065-8138
(502) 633-1007
(502) 805-1511

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
31005496A
IN
225X00000X
Occupational Therapist
5201008405
MI
225X00000X
Occupational Therapist
Primary
R5721
KY

Other

Enumeration date
10/01/2013
Last updated
04/11/2019
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