Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 2683 | AL |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 2683 | AL |
NPI | 1043490691 |
---|---|
Provider Name | Keri Rhodes Smith |
First Address | Dothan, AL 36303-1997 |
Second Address | Dothan, AL 36303-1997 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2007 |
Last Update Date | 13/11/2007 |