Healthcare Provider Details

I. General information

NPI: 1831341742
Provider Name (Legal Business Name): ANDREA LEE SMITH OTR/L, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANDREA LEE RANSOM

II. Dates (important events)

Enumeration Date: 10/22/2008
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 S LOUISE AVE
SIOUX FALLS SD
57108-6029
US

IV. Provider business mailing address

6100 S LOUISE AVE
SIOUX FALLS SD
57108-6029
US

V. Phone/Fax

Practice location:
  • Phone: 605-504-4263
  • Fax: 605-504-4264
Mailing address:
  • Phone: 605-504-4263
  • Fax: 605-504-4264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number0200
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0200
License Number StateSD
# 3
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number0200
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: