Christie M Polk Smith, LCOTA

Individual provider Active NPI Occupational Therapy Assistant · Calhoun, LA

NPI 1275938458 · NPPES record last updated Oct 29, 2014

Key facts

NPI
1275938458
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
OTA.200421 (LA)
Practice address
516 Leckie Rd
Calhoun, LA 71225-9085
Phone
(318) 331-3862
NPI assigned
Oct 29, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
OTA.200421LAMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA.200421 LA Yes

Addresses

Primary practice location

516 Leckie Rd
Calhoun, LA 71225-9085

Mailing address

PO Box 309
Calhoun, LA 71225-0309
Phone (318) 331-3862

Other providers in Calhoun, LA

All providers in Calhoun, LA · Occupational Therapy Assistant in Louisiana

Sources for this page

Verify at the official NPI Registry.