Individual
DONNEISHA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1200 W 15TH ST, MONAHANS, TX 79756-8301
(616) 975-5092
Mailing address
3773 N 58TH BLVD, MILWAUKEE, WI 53216-2850
(414) 839-4028
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
212887
TX
Other
Enumeration date
03/03/2015
Last updated
03/03/2015
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