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Individual

AMBER DAWN SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
52565 STATE ROAD 933, SOUTH BEND, IN 46637-3257
(574) 247-7044
Mailing address
52565 STATE ROAD 933, SOUTH BEND, IN 46637-3257
(574) 213-4721

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32002152A
IN
224Z00000X
Occupational Therapy Assistant
5202007559
MI

Other

Enumeration date
07/08/2015
Last updated
07/08/2015
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