Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1053651281 |
---|---|
Provider Name | Margaret Reiko Smith |
First Address | Sparks, NV 89435-0396 |
Second Address | Sparks, NV 89431-0816 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2013 |
Last Update Date | 25/02/2013 |