Lisa Annette Smith, B.S. IN IECE

Individual provider Active NPI Developmental Therapist · Strunk, KY

NPI 1386980928 · NPPES record last updated Aug 16, 2013

Key facts

NPI
1386980928
Entity type
Individual (NPI type 1)
Primary specialty
Developmental Therapist 222Q00000X
License
000071339 (KY)
Practice address
1633 Murphy Ridge Rd
Strunk, KY 42649-9358
Phone
(606) 354-3818
NPI assigned
Jan 1, 2013
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
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
000071339KYMDDevelopmental Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X 000071339 KY Yes

Addresses

Primary practice location

1633 Murphy Ridge Rd
Strunk, KY 42649-9358

Mailing address

1633 Murphy Ridge Rd
Strunk, KY 42649-9358
Phone (606) 354-3818

Other providers in Strunk, KY

All providers in Strunk, KY · Developmental Therapist in Kentucky

Sources for this page

Verify at the official NPI Registry.