Individual
MS. KELLY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
23361 MADERO, SUITE 200, MISSION VIEJO, CA 92691-2715
(949) 581-8239
(949) 859-0849
Mailing address
25842 EMPRESA, MISSION VIEJO, CA 92691-5735
(949) 581-8239
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT11279
CA
Other
Enumeration date
08/30/2010
Last updated
08/30/2010
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