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NPI Code Detail

MEDICARE: DILYN NAOMI SMITH OTR

MEDICARE: DILYN NAOMI SMITH OTR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist5201009321MI

General Provider Information

NPI Number : 1528424421
Entity Type Code : Individual
Provider Name (Legal Business Name) : DILYN NAOMI SMITH OTR
Provider Business Mailing Address
First Line : 812 E JOLLY RD STE 210
Second Line : ATTN: DIANA SMITH
City : LANSING
State : MI
Zip : 48910-6821
Country : US
Telephone Number : 517-346-8200
Fax Number : 517-346-8291
Provider Business Practice Location Address
First Line : 5150 WARDCLIFF DR
Second Line :
City : EAST LANSING
State : MI
Zip : 48823-3851
Country : US
Telephone Number : 517-664-5320
Fax Number : 517-664-5325
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2016
Last Update Date : 01/07/2016

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