Individual
IESHA BRIDGES SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
170 E GRIFFITH ST APT 209, JACKSON, MS 39201-1396
(404) 991-0367
Mailing address
170 E GRIFFITH ST APT 209, JACKSON, MS 39201-1396
(404) 991-0367
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT2921
MS
Other
Enumeration date
09/25/2014
Last updated
09/25/2014
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