Individual
SANDREA R SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
308 W MAIN ST, MORRISON, IL 61270-2439
(847) 848-7559
Mailing address
308 W MAIN ST, MORRISON, IL 61270-2439
(847) 848-7559
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.005115
IL
Other
Enumeration date
07/24/2019
Last updated
07/24/2019
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