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Individual

RAISSA J SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
3501 FENWICK PARK PL, APT F, LOUISVILLE, KY 40220-5844
(606) 584-9999
Mailing address
3501 FENWICK PARK PL, APT F, LOUISVILLE, KY 40220-5844
(606) 584-9999

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
261QM1300X
Multi-Specialty Clinic/Center
Primary
134651
KY

Other

Enumeration date
06/02/2014
Last updated
09/14/2020
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