Individual
LISA JANELL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2221 W DETROIT ST, BROKEN ARROW, OK 74012-3628
(918) 615-6492
(918) 615-6493
Mailing address
2221 W DETROIT ST, BROKEN ARROW, OK 74012-3628
(918) 615-6492
(918) 615-6493
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
09/03/2009
Last updated
09/03/2009
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