Healthcare Provider Details

I. General information

NPI: 1629353438
Provider Name (Legal Business Name): MS. HANNAH LEIGH SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2011
Last Update Date: 10/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

871 OLD ALICE ROAD SUITE 600
BROWNSVILLE TX
78520
US

IV. Provider business mailing address

3102 HAINE DRIVE APT. 216
HARLINGEN TX
78550
US

V. Phone/Fax

Practice location:
  • Phone: 956-541-2120
  • Fax: 956-541-2502
Mailing address:
  • Phone: 952-564-8075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: