Provider Demographics
NPI:1669664421
Name:SMITH, SHERYL A (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:SHERYL
Middle Name:A
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:REDFIELD
Mailing Address - State:SD
Mailing Address - Zip Code:57469-1214
Mailing Address - Country:US
Mailing Address - Phone:605-472-0182
Mailing Address - Fax:
Practice Address - Street 1:312 E 1ST ST
Practice Address - Street 2:
Practice Address - City:REDFIELD
Practice Address - State:SD
Practice Address - Zip Code:57469-1214
Practice Address - Country:US
Practice Address - Phone:605-472-0182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0559225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist