Individual
JADE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
1244 E BETHANY HOME RD APT 33A, PHOENIX, AZ 85014-2043
(505) 290-3917
Mailing address
1244 E BETHANY HOME RD APT 33A, PHOENIX, AZ 85014-2043
(505) 290-3917
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTH-008482
AZ
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
08/01/2020
Last updated
06/14/2021
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