Individual
JORDAN VICTORIA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
810 BELLAIRE ST, JACKSONVILLE, TX 75766-9045
(903) 589-5300
Mailing address
16734 COUNTY ROAD 192, TYLER, TX 75703-7252
(903) 574-5498
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
215270
TX
Other
Enumeration date
08/29/2018
Last updated
08/29/2018
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