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General NPI Number Information
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NPI Number | 1164903043
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Entity Type | Individual
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Provider Name | JANET L. SMADE OTL
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Gender | Female
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Dates
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Enumeration Date | 08/28/2018
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Last Update Date | 01/11/2026
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Provider Practice Location Address
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Address Line | 1007 BUNCE AVE
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City | MARYSVILLE
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State | MI
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Zip | 48040-1303
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Country | US
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Telephone | 810-335-0766
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Fax |
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Provider Business Mailing Address
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Address Line | 1007 BUNCE AVE
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City | MARYSVILLE
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State | MI
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Zip | 48040-1303
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5201002118
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License Number State | MI
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