Provider Demographics
NPI:1497094437
Name:MCDONALD-SMITHSON, MARLENE (MOT, OTR)
Entity Type:Individual
Prefix:
First Name:MARLENE
Middle Name:
Last Name:MCDONALD-SMITHSON
Suffix:
Gender:F
Credentials:MOT, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 ARCHER AVE
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:IL
Mailing Address - Zip Code:62441-1556
Mailing Address - Country:US
Mailing Address - Phone:812-208-5963
Mailing Address - Fax:
Practice Address - Street 1:910 ARCHER AVE
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:IL
Practice Address - Zip Code:62441-1556
Practice Address - Country:US
Practice Address - Phone:812-208-5963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-12
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist