Provider Demographics
NPI:1467706143
Name:SMITH, MARGARET J (COTA)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:J
Last Name:SMITH
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 MONTEGO DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45503-6464
Mailing Address - Country:US
Mailing Address - Phone:934-390-9913
Mailing Address - Fax:934-346-0410
Practice Address - Street 1:2150 MONTEGO DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503-6464
Practice Address - Country:US
Practice Address - Phone:934-390-9913
Practice Address - Fax:934-346-0410
Is Sole Proprietor?:No
Enumeration Date:2012-11-02
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA 2163224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant