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General NPI Number Information
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NPI Number | 1205248911
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Entity Type | Individual
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Provider Name | CASEY O'MALLEY SMITH M.S.O.T., OTR/L
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Gender | Female
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Dates
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Enumeration Date | 05/29/2014
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Last Update Date | 05/29/2014
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Provider Practice Location Address
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Address Line | 1913 ALFRESCO PL # 1
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City | LOUISVILLE
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State | KY
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Zip | 40205-1809
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Country | US
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Telephone | 502-836-7246
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Fax |
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Provider Business Mailing Address
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Address Line | 1913 ALFRESCO PL # 1
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City | LOUISVILLE
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State | KY
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Zip | 40205-1809
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Country | US
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Telephone | 502-836-7246
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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 | R5998
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License Number State | KY
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