Provider Demographics
NPI:1699368282
Name:SMITH, JOAN HOPE (OT/L, CAPS)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:HOPE
Last Name:SMITH
Suffix:
Gender:F
Credentials:OT/L, CAPS
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:HOPE
Other - Last Name:ALLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1901 SELKIRK DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-2225
Mailing Address - Country:US
Mailing Address - Phone:336-430-4294
Mailing Address - Fax:
Practice Address - Street 1:175 DEER RUN RD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-2863
Practice Address - Country:US
Practice Address - Phone:434-797-5531
Practice Address - Fax:434-797-5529
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2761225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2761OtherNORTH CAROLINA BOARD OF OCCUPATIONAL THERAPY