Provider Demographics
NPI:1497954127
Name:SMITH, ERIN MICHELLE (MS, OT)
Entity Type:Individual
Prefix:MISS
First Name:ERIN
Middle Name:MICHELLE
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS, OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 WHARTON RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-5267
Mailing Address - Country:US
Mailing Address - Phone:609-314-0532
Mailing Address - Fax:
Practice Address - Street 1:1203 NECK RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-3909
Practice Address - Country:US
Practice Address - Phone:609-386-3520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00385700225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics