Individual
KELLY M SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.S., C.B.I.S. EXP
Contact information
Practice address
2880 RENFREW ST., ANN ARBOR, MI 48105-1454
(734) 649-6749
Mailing address
11415 LAUDERDALE CT, PINCKNEY, MI 48169-9535
(734) 878-2919
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
1018
MI
225400000X
Rehabilitation Practitioner
1018
VA
Other
Enumeration date
03/08/2012
Last updated
03/08/2012
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