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General NPI Number Information
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NPI Number | 1194871632
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Entity Type | Individual
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Provider Name | MARIE PATRICIA SMITH B.A.
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Gender | Female
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 06/17/2013
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Provider Practice Location Address
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Address Line | 801 E CHAPMAN AVE
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City | FULLERTON
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State | CA
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Zip | 92831-3839
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Country | US
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Telephone | 714-680-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 1460 E HOLT AVE STE 180
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City | POMONA
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State | CA
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Zip | 91767-5853
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Country | US
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Telephone | 909-865-0555
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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 | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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