Individual
MRS. DOLLY BARRETT SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPS, LOTR, CHT
Contact information
Practice address
217 SPRUCE ST, MANDEVILLE, LA 70471-2542
(985) 630-6711
Mailing address
217 SPRUCE ST, MANDEVILLE, LA 70471-2542
(985) 630-6711
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
Z10150
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5X738CQ94
MEDICARE PTAN NUMBER
LA
Enumeration date
10/12/2005
Last updated
12/03/2012
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