Provider Demographics
NPI:1710184551
Name:SMITH, JOANNE MARIE (COTA)
Entity Type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:MARIE
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 1:2760 AIRPORT DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-2284
Mailing Address - Country:US
Mailing Address - Phone:614-357-0519
Mailing Address - Fax:
Practice Address - Street 1:951 HICKORY CREEK DR
Practice Address - Street 2:
Practice Address - City:TEMPERANCE
Practice Address - State:MI
Practice Address - Zip Code:48182-2327
Practice Address - Country:US
Practice Address - Phone:734-206-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5202007275224Z00000X
OHOTA.03019224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant