Sandrea R Smith

Individual provider Active NPI Occupational Therapy Assistant · Morrison, IL

NPI 1962056358 · NPPES record last updated Jul 24, 2019

Key facts

NPI
1962056358
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
057.005115 (IL)
Practice address
308 W Main St
Morrison, IL 61270-2439
Phone
(847) 848-7559
NPI assigned
Jul 24, 2019
Sex
Female
Sole proprietor
No

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
057.005115ILMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 057.005115 IL Yes

Addresses

Primary practice location

308 W Main St
Morrison, IL 61270-2439

Mailing address

308 W Main St
Morrison, IL 61270-2439
Phone (847) 848-7559

Electronic endpoints

TypeEndpointUseAffiliation
Other URL srsmith2088@gmail.com

Other providers in Morrison, IL

All providers in Morrison, IL · Occupational Therapy Assistant in Illinois

Sources for this page

Verify at the official NPI Registry.