Healthcare Provider Details

I. General information

NPI: 1982491148
Provider Name (Legal Business Name): KASEY SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1497 S QUEEN ST
YORK PA
17403-3852
US

IV. Provider business mailing address

5116 DARLINGTON RD
YORK PA
17408-6009
US

V. Phone/Fax

Practice location:
  • Phone: 717-430-8896
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOP010649
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: