Individual
VICKIE LAVERNE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2510 NW EDENBOWER BLVD, ROSEBURG, OR 97471-8899
(541) 440-3052
Mailing address
126 DOBIE CT, ROSEBURG, OR 97470-1481
(541) 255-9927
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1009487
OR
Other
Enumeration date
02/17/2012
Last updated
02/17/2012
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