Provider Demographics
NPI:1841537206
Name:SMITH, KATHRYN NAOMI
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:NAOMI
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:478 HALLADAY AVE W
Mailing Address - Street 2:
Mailing Address - City:SUFFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06078-1006
Mailing Address - Country:US
Mailing Address - Phone:860-922-5248
Mailing Address - Fax:
Practice Address - Street 1:478 HALLADAY AVE W
Practice Address - Street 2:
Practice Address - City:SUFFIELD
Practice Address - State:CT
Practice Address - Zip Code:06078-1006
Practice Address - Country:US
Practice Address - Phone:860-922-5248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-04
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist