Individual
MRS. ALLEN ERMITA SMITH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1335 ARIANA ST, LAKELAND, FL 33803-1879
(863) 413-0802
(863) 413-0812
Mailing address
1335 ARIANA ST, LAKELAND, FL 33803-1879
(863) 413-0802
(863) 413-0812
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
225X00000X
OCCUPATIONAL THERAPIST
FL
Enumeration date
06/07/2006
Last updated
07/08/2007
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