Individual
JENNIFER SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
14585 59TH AVE N, PLYMOUTH, MN 55446-3872
(763) 519-1350
Mailing address
11137 BITTERSWEET ST NW, COON RAPIDS, MN 55433-3555
(763) 229-2426
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
202232
MN
Other
Enumeration date
07/03/2023
Last updated
07/06/2023
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