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General NPI Number Information
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NPI Number | 1518446228
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Entity Type | Individual
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Provider Name | MEGAN BROOKE SMITH OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/13/2018
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Last Update Date | 08/13/2018
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Provider Practice Location Address
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Address Line | 1900 LAUDERDALE DR
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City | RICHMOND
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State | VA
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Zip | 23238-3933
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Country | US
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Telephone | 804-521-9271
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Fax |
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Provider Business Mailing Address
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Address Line | 113 S DAVIS AVE APT 6120
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City | RICHMOND
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State | VA
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Zip | 23220-5156
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Country | US
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Telephone | 336-803-1694
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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 | 0119007567
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License Number State | VA
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