Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | ||
N | 225XF0002X | Feeding, Eating & Swallowing | ||
Y | 225XP0200X | Occupational Therapist - Pediatrics | 117549 | TX |
NPI | 1417318049 |
---|---|
Provider Name | Mrs. Shayli Anne Smith |
First Address | Abilene, TX 79605-4603 |
Second Address | Abilene, TX 79605-4603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2016 |
Last Update Date | 02/10/2017 |