Individual
KELLY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LOTA
Contact information
Practice address
1000 1ST ST E, HUMBLE, TX 77338-4924
(281) 540-2001
Mailing address
4615 RIVERSIDE OAKS DR, KINGWOOD, TX 77345-1296
(713) 855-0301
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
213713
TX
Other
Enumeration date
01/11/2017
Last updated
01/11/2017
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